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. 2019 Mar 15;33(4):655-664.
doi: 10.1097/QAD.0000000000002101.

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

David M MacDonald  1   2 , Alexander D Zanotto  1   2 , Gary Collins  2 , Jason V Baker  3 , Marcin Czarnecki  4 , Eliana Loiza  5 , Daniel E Nixon  6 , Vasileios Papastamopoulos  7 , Chris H Wendt  1   2 , Robin Wood  8 , Ken M Kunisaki  1   2 ; INSIGHT START Pulmonary Substudy Group
Affiliations

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

David M MacDonald et al. AIDS. .

Abstract

Objective: The aim of this study was to analyse 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 modelled 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 forced expiratory volume in 1 s (FEV1), forced vital capacity (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, high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, IL-27, serum amyloid A, soluble intercellular adhesion molecule (sICAM)-1, soluble vascular cell adhesion molecule (sVCAM)-1, albumin and total bilirubin.

Results: Among 903 included participants, baseline median age was 36 years, CD4+ cell count was 647 cells/μl, 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 (3293 spirometry-years of follow-up).

Conclusion: 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 more than 500 cells/μl.

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Conflict of interest statement

Declaration of interests:

GC, JVB, MC, EL, VP, DEN and KMK received grant support from the National Institutes of Health (R01 HL096453, UM1 AI068641 and UM AI120197) for conduct of this study.

Other interests:

DMM: No conflicts to report

ADZ: No conflicts to report

GC: No other conflicts to report

JVB: No other conflicts to report

MC: No other conflicts to report

EL: No other conflicts to report

DEN: No other conflicts to report

VP: No other conflicts to report

CHW: No other conflicts to report

RW: No other conflicts to report

KMK: Consultancy fees from GlaxoSmithKline

Figures

Figure 1.
Figure 1.
Study participant flow diagram.
See this image and copyright information in PMC

References

    1. Triplette M, Crothers K, Attia EF. Non-infectious Pulmonary Diseases and HIV. Curr HIV/AIDS Rep 2016; 13:140–148. - PubMed
    1. Hirschtick RE, Glassroth J, Jordan MC, Wilcosky TC, Wallace JM, Kvale PA, et al. Bacterial Pneumonia in Persons Infected with the Human Immunodeficiency Virus. N Engl J Med 1995; 333:845–851. - PubMed
    1. Pefura-Yone EW, Fodjeu G, Kengne AP, Roche N, Kuaban C. Prevalence and determinants of chronic obstructive pulmonary disease in HIV infected patients in an African country with low level of tobacco smoking. Respir Med 2015; 109:247–254. - PubMed
    1. Crothers K, Butt AA, Gibert CL, Rodriguez-Barradas MC, Crystal S, Justice AC. Increased COPD among HIV-positive compared to HIV-negative veterans. Chest 2006; 130:1326–1333. - PubMed
    1. Bigna JJ, Kenne AM, Asangbeh SL, Sibetcheu AT. Prevalence of chronic obstructive pulmonary disease in the global population with HIV: A systematic review and meta-analysis. Lancet Glob Health 2017; 6:e193–e202. - PubMed