Abstract
Background and aim
Biomarkers of monocyte-macrophages activation and inflammation in plasma such as interleukin-18 (IL-18), soluble leukocyte differentiation antigen 14 (sCD14) and sCD163 are associated with disease severity and prognosis in HIV-1 infected patients, however, their relationships with efficacy of antiretroviral therapy (ART) need further investigation. We aimed to characterize and explore the clinical significance of plasma IL-18, sCD14 and sCD163 in this population.
Methods
This was a retrospective cohort study consisting of HIV-1 infected patients enrolled in a randomized, controlled, open-label, non-inferiority trial (ALTERLL study), with follow-up time points including initiation of ART (baseline), 12-, 24- and 48-weeks of treatment. Plasma levels of IL-18, sCD14 and sCD163 were measured using enzyme-linked immunosorbent assay method. Viral suppression was defined as HIV-1 RNA <20 copies/mL.
Results
Among the 193 studied pa tients (median age of 29.0 years, 180 males), IL-18 and sCD163 had U-shaped regression curves and sCD14 had an inverted U-shaped regression curve while virus was decreasing and immune function recovered. Patients with higher levels of IL-18 or lower levels of sCD163 at baseline were less likely to achieve viral suppression at week 12 or week 24 of treatment, respectively. In multivariate analysis, baseline sCD163 ≤500 pg/mL (aOR 0.33, 95%CI 0.16-0.68) was independently associated with lower rate of viral suppression at week 24 of treatment.
Conclusion
We demonstrated different dynamic changes among IL-18, sCD14 and sCD163 after ART. Baseline sCD163 level could be a potential predictor of early virological response to ART. Further validation and mechanistic research are needed.
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