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J Infect Dis. 2018 Jan 30;217(4):521-528. doi: 10.1093/infdis/jix586.

Can Biomarkers Advance HIV Research and Care in the Antiretroviral Therapy Era?

Author information

1
VA Connecticut Healthcare System West Haven, Yale University, New Haven, Connecticut.
2
School of Medicine, Yale University, New Haven, Connecticut.
3
School of Public Health, Yale University, New Haven, Connecticut.
4
Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.
5
Division of Geriatric Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora.
6
Division of Experimental Medicine, Department of Medicine, University of California-San Francisco.
7
Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, Illinois.
8
Office of AIDS Research, National Institutes of Health, Bethesda, Maryland.
9
Department of Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Colchester.
10
Department of Biochemistry, University of Vermont Larner College of Medicine, Colchester.

Abstract

Despite achieving human immunodeficiency virus type 1 (HIV-1) RNA suppression below levels of detection and, for most, improved CD4+ T-cell counts, those aging with HIV experience excess low-level inflammation, hypercoagulability, and immune dysfunction (chronic inflammation), compared with demographically and behaviorally similar uninfected individuals. A host of biomarkers that are linked to chronic inflammation are also associated with HIV-associated non-AIDS-defining events, including cardiovascular disease, many forms of cancer, liver disease, renal disease, neurocognitive decline, and osteoporosis. Furthermore, chronic HIV infection may interact with long-term treatment toxicity and weight gain after ART initiation. These observations suggest that future biomarker-guided discovery and treatment may require attention to multiple biomarkers and, possibly, weighted indices. We are clinical trialists, epidemiologists, pragmatic trialists, and translational scientists. Together, we offer an operational definition of a biomarker and consider how biomarkers might facilitate progress along the translational pathway from therapeutic discovery to intervention trials and clinical management among people aging with or without HIV infection.

KEYWORDS:

Biomarker; HIV; index; inflammation; therapeutic discovery

PMID:
29165684
PMCID:
PMC5853399
[Available on 2019-01-30]
DOI:
10.1093/infdis/jix586

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