Journal
AIDS
Volume 26, Issue 11, Pages 1371-1385Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0b013e328354f4fb
Keywords
abacavir; C-reactive protein; endothelial activation markers; inflammation markers; interleukin-6; TNF alpha
Categories
Funding
- CTU [AI0694241, UL1-RR033176, AI069474, U01AI069495, AI069434, UL1 RR025014, 5 U0I AI069415-03, AI069513, AI69501, ACTG, 5U01AI069494, 5-U01 AI069423-03, AI69432, AI 27661, 1 U01 AI069494-01, 5U01AI025859, AI27668, AI27665, AI069532, AI69450, RR025780, 3U01AI046376-05S4, P30-AI0450008-11, U01 AI069472-04, UOI AI 069472, U01AI069511-02, N01 AI72626, UO1Al69418-01/CFAR, P30Al050409, AI27658, U01 AI069471, AI34853, 1U01AI069424-01, UL1RR024979, 5U01 AI069 484-02, AI32782, U01 AI069419, AI46339-01, MO1 RR 00095]
- GCRC [UL1 RR024992, M01 RR00750, UL1 RR 024160]
- UNC CFAR [P30 AI050410 (-11)]
- UNC CTRC [UL 1RR 025747]
- CTSA [UL1 RR025005]
- CFAR [UO1-AI069467-04]
- CTSC [UL1 RR024996]
- National Institute of Allergy and Infectious Diseases [U01AI068636, AI068634, AI38855, AI065348]
- Bristol Myers Squibb
- GlaxoSmithKline
- Gilead Sciences
- Pfizer
- Abbott Laboratories
- Merck
- Gilead
- ViiV
- BMS
- Tibotec
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Background: The effect of specific antiretrovirals on inflammation is unclear. Methods: A5224s was a substudy of A5202, which randomized HIV-infected treatment-naive patients to blinded abacavir/lamivudine (ABC/3TC) or tenofovir/emtricitabine (TDF/FTC) with open-label efavirenz (EFV) or atazanavir/ritonavir (ATV/r) in a factorial design. Our analysis compared changes in inflammation markers from baseline to week 24 between ABC/3TC and TDF/FTC. Secondary analyses included changes at week 96 and comparisons of EFV vs. ATV/r. Results: Analyses included 244 patients (85% male, 48% white non-Hispanic), median age 39 years, HIV-1 RNA 4.6 log(10) copies/ml, CD4 240 cells/mu l. TNF-alpha, soluble receptors of TNF-alpha (sTNFR)-I and II, soluble vascular cellular adhesion molecule (sVCAM)-1 and soluble intercellular adhesion molecule (sICAM)-1 decreased significantly at weeks 24 and 96, without significant differences between components (P >= 0.44). At week 24, ABC/3TC had a greater high-sensitivity C-reactive protein (hsCRP) mean fold change than TDF/FTC {1.43 vs. 0.88, estimated mean fold change percentage difference [Delta] 61.5% [95% confidence interval (CI) 13.6%, 129.5%]; P = 0.008}. Similar results were seen at week 96 (P = 0.021). At week 24 (but not 96), EFV had a greater hsCRP mean fold change than ATV/r [1.41 vs. 0.88; Delta 60.2% (12.6%, 127.7%); P = 0.009]. IL-6 decreased significantly at week 24 with TDF/FTC but not with ABC/3TC (between-components P = 0.019). At week 96, IL-6 decreased significantly in both nucleoside reverse transcriptase inhibitor components (between-components P = 0.11). IL-6 changes were not significantly different between ATV/r and EFV at either time point (P >= 0.89). Conclusions: Soluble TNF-receptors and adhesion molecules decreased following treatment initiation and did not differ by regimens. Differences were seen on hsCRP and IL-6 changes with ABC/3TC vs. TDF/FTC and on hsCRP with EFV vs. ATV/r. (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
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