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Associations between baseline biomarkers and lung function in HIV-positive individuals.

Macdonald DM, et al. AIDS. 2018.


OBJECTIVE: To analyze the association of baseline biomarker data with cross sectional lung function and subsequent decline in lung function in HIV-positive persons.

DESIGN: Lung function was modeled in all START pulmonary substudy participants who had baseline biomarker data and good-quality spirometry. In longitudinal analyses we restricted to those participants with at least one good-quality follow up spirometry test.

METHODS: We performed linear regression of baseline FEV1, FVC, and FEV1/FVC and their longitudinal slopes on log2-transformed baseline biomarkers with adjustment for age, sex, race, region, smoking status, baseline CD4+ T-cell counts, and baseline HIV-RNA. Biomarkers included D-dimer, hsCRP, IL-6, IL-27, serum amyloid A, sICAM-1, sVCAM-1, albumin, and total bilirubin.

RESULTS: Among 903 included participants, baseline median age was 36 years, CD4 count was 647 cells/mm, and 28.5% were current smokers. In adjusted analyses, elevated markers of systemic inflammation (hsCRP, IL-6, and serum amyloid A) were associated with lower baseline FEV1 and FVC. Elevated D-dimer and IL-6 were associated with worse airflow obstruction (lower FEV1/FVC). Despite these cross-sectional associations at baseline, no associations were found between baseline biomarkers and subsequent longitudinal lung function decline over a median follow-up time of 3.9 years (3,293 spirometry-years of follow up).

CONCLUSIONS: Commonly available biomarkers, in particular markers of systemic inflammation, are associated with worse cross-sectional lung function, but do not associate with subsequent lung function decline among HIV-positive persons with early HIV infection and baseline CD4+ T-cell counts >500 cells/mm.


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