Biomarkers of inflammation increase during acute HIV infection and remain elevated despite early suppressive antiretroviral therapy, according to a study presented at CROI 2015, in Seattle, Washington.
The study, presented by Netanya Sandler Utay, M.D., followed 78 acutely HIV-infected individuals and 109 HIV-negative individuals from Thailand, from diagnosis or enrollment to 96 weeks.
The HIV-positive individuals were diagnosed within a median of 16 days after infection. They were then started on antiretroviral therapy within an average of three days after diagnosis. About 92% of the HIV-positive individuals were male and the median age was 28. Meanwhile, about 77% of the HIV-negative individuals were male and the median age was 27.
Researchers measured biomarkers of inflammation, including: D-dimer, C-reactive protein (CRP), hyaluronic acid (HA), soluble CD14 (sCD14) and intestinal fatty acid binding protein (I-FABP). These biomarkers were all significantly higher in acutely infected patients at time of diagnosis compared to the HIV-negative individuals.
Looking at the specific biomarkers in the HIV-positive patients:
- sCD14 (a biomarker of monocyte activation) levels decreased by week 12, but were higher at all time points after infection compared to the HIV-negative controls.
- HA (a biomarker of fibrosis) levels decreased at week 2, but were higher at all time points after infection compared to the HIV-negative controls.
- CRP (a biomarker of inflammation) levels decreased by week 12, but were higher at all time points after infection (except week 48) compared to the HIV-negative controls.
- I-FABP (a biomarker of enterocyte turnover) levels increased at week 2 and were higher at all time points after infection compared to the HIV-negative controls.
- D-dimer (a biomarker of coagulation) increased at weeks 0 and 2, but then significantly decreased starting at week 12 and ended up being comparable to the HIV-negative controls.
With the exception of D-dimer, these biomarkers of inflammation remained elevated in patients who were treated during acute HIV infection.
"The inflammatory damage caused by HIV may not be completely prevented by starting [antiretroviral therapy] during acute HIV infection," the authors stated.
However, while these biomarkers persist despite treatment during acute HIV infection, the levels are lower than levels seen in individuals who start treatment during chronic infection, the researchers noted.
View the full study presentation here.