Plasma biomarkers of HIV-related systemic inflammation and immune activation in sub-Saharan Africa before and during suppressive antiretroviral therapy.
Kroeze S., Wit FW., Rossouw TM., Steel HC., Kityo CM., Siwale M., Akanmu S., Mandaliya K., de Jager M., Ondoa P., Reiss P., Rinke de Wit TF., Kootstra N., Hamers RL.
We evaluated immune biomarker profiles in HIV-infected adults (n=398) from 5 African countries. Although all biomarkers decreased after ART initiation, CXCL10, LBP, CRP, sCD163 and sCD14 were significantly higher during ART than in an HIV-negative reference group (n=90), indicating persistent monocyte/macrophage activation, inflammation and microbial translocation. Before ART initiation, high HIV viral load was associated with elevated CXCL10 and tuberculosis coinfection was associated with elevated sCD14. High pre-ART levels of each biomarker strongly predicted residual immune activation during ART. CCL2, LBP, CRP, IL-6 were differentially expressed between countries. Further research is needed on the clinical implications of residual immune dysregulation.