TY - JOUR
TI - Elevated serum levels of soluble immune activation markers are
associated with increased risk for death in HAART-naive HIV-1-infected
patients
AU - Sipsas, NV
AU - Sfikakis, PP
AU - Touloumi, G
AU - Pantazis, N
AU - Choremi,
AU - H
AU - Kordossis, T
JO - AIDS Patient Care and STDs
PY - 2003
VL - 17
TODO - 4
SP - 147-153
PB - MARY ANN LIEBERT INC PUBL
SN - 1087-2914, 1557-7449
TODO - 10.1089/108729103321619755
TODO - null
TODO - The aim of this study was to determine the serum levels of soluble
markers reflecting different aspects of immune activation in
HIV-1-infected patients, and assess their prognostic significance for
occurrence of AIDS-related death before the advent of the highly active
antiretroviral treatment (HAART). Serum concentrations of the soluble
forms of interleukin-2 receptors (sIL-2R), intercellular adhesion
molecule-1 (sICAM-1), and E-selectin (sEs) have been determined in a
cohort of 64 HIV-1-infected patients, between 1990-1993. The patients
were followed prospectively with regular visits at the outpatient
department. Follow-up time was censored at January 1, 1997, the date
after which HAART was introduced. The median follow-up time was 46
months (range, 2-78 months). By the end of follow-up, 34 subjects had
died. Baseline levels of all three soluble markers were significantly
lower in subjects who remained alive during the follow-up compared to
subjects who died. Univariate analysis showed that individual sIL-2R and
sICAM-1, but not sEs measurements, were significantly associated with
time to death (p = 0.008 and 0.003, respectively). Even after adjustment
for age and CD4(+) T-cell counts sIL-2R measurements remained
significantly prognostic. Sensitivity analysis using follow-up time to
year 2000 confirmed these results. Our data suggest that assessment of
the immune activation status using the easily measured levels of
circulating markers may provide additional information about the risk of
AIDS-related death. Further studies are needed to assess the effect of
HAART on the levels of immune activation markers and their prognostic
value.
ER -