Pneumoproteins and biomarkers of inflammation and coagulation do not predict rapid lung function decline in people living with HIV

Abstract Chronic obstructive pulmonary disease (COPD) is among the leading causes of death worldwide and HIV is an independent risk factor for the development of COPD. However, the etiology of this increased risk and means to identify persons with HIV (PWH) at highest risk for COPD have remained elu...

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Autores principales: David M. MacDonald, Sarah Samorodnitsky, Chris H. Wendt, Jason V. Baker, Gary Collins, Monica Kruk, Eric F. Lock, Roger Paredes, Selvamuthu Poongulali, Danielle O. Weise, Alan Winston, Robin Wood, Ken M. Kunisaki, INSIGHT START Pulmonary Substudy Group, Bitten Aagaard, Paul Jansson, Mary Pearson, Abdel G. Babiker, Alejandro Arenas‐Pinto, Nafisah B Atako, Edward A. Dennis, S. Forcat, Fleur Hudson, B. Jackson, Daphne Maas, Caitlin G. Purvis, C. T. Russell, Sean Emery, Cara Donahue Carey, Megan Clewett, Simone Jacoby, Fred M. Gordin, Michael J. Vjecha, Alejandro Sanchez, Guido Ruggero Loria, Marcela Doldán, André de Moricz, K. Tillmann, V Müller, Giota Touloumi, Vicky Gioukari, Olga Anagnostou, Pablo Herrero, Patricia López, Anchalee Avihingsanon, Patsamon Rerksirikul, Site Investigators by Country and institution, Eliana Loiza, Verónica Mingrone, Sofia Lupo, F Marconi, D. Daniel, Ana Crinejo, Martyn A. French, L. Barba, Diane Rowling, E. Warzywoda, Mark Bloch, Swati Agrawal, Dominic E. Dwyer, Bruce Taylor, Lida van Petersen, Luc Mertens, S De Wit, K. Kabamba, Marcelo Wolff, G Allendes, Matti Ristola, O. Debham, Henrik Jessen, Arne Jessen, S. Wiebecke, Hartwig Klinker, Gerd Fätkenheuer, Clara Lehmann, I. Knaevelsrud, M. Rittweger, Albrecht Stöhr, Karl S. Oláh, Bernhard Schaaf, Martin Hower, Thomas Harrer, Ellen G. Harrer, A. Skoutelis, Vasilios Papastamopoulos, Simeon Metallidis, Οlga Tsachouridou, Sanjay Pujari, Abhishek Chitalikar, N. Kumarasamy, Faith Esther Beulah, Eduardo Shahar, Eynat Kedem, Dan Turner, Juan Sierra Madero, Carlos Madrigal, Kamal Marhoum El Filali, I. Erradey, Ernest Ekong, Nnakelu Eriobu, Javier Valencia, Manuel Garza-León, Esmelda Montalbán, Jorge Alave, Raúl Salazar, Jesús Vega, M. del Portal, Fernando Mendo, Elżbieta Bąkowska, Anna Ignatowska, Marcin Czarnecki, Aleksandra Szymczak, M. Rattley, S. Pillay, Rosie Mngqibisa, Thoko Ndaba, Paradise Madlala, Vicente Estrada, M.E. Rodrigo, M. Gutierrez, José Muñóz, David Dalmau, Cristina Badía, Bonaventura Clotet, Josep M. Llibre, Kiat Ruxrungtham, Sivaporn Gatechompol, Sasisopin Kiertiburanakul, Nutaporn Sanmeema, Chureeratana Bowonwatanuwong, U. Ampunpong, Wisit Prasithsirikul, Supeda Thongyen, Ploenchan Chetchotisakd, Siriluck Anunnatsiri, Winai Ratanasuwan, Peerawong Werarak, Cissy Kityo, H. Mugerwa, Paula Munderi, Joseph Lutaakome, Amanda Clarke, Andrew Bexley, Sayantan Das, Amandip Sahota, C R Emerson, Shannon McKernan, Margaret Johnson, M Youle, Jonathan Ross, J. W. Harding, Stephen Kegg, Tarik Moussaoui, Fangfang Chen, Sharonann Lynch, Andrew De Burgh-Thomas, W. A. I. P. Karunaratne, David H. Dockrell, C. Bowman, Borja Mora‐Peris, David Chadwick, Peter Lambert, Neeraj Desai, W. Carter, Keith Henry, R. Givot, M. Chow, B. Holloway, Stephen E. Weis, I. Vecino, Richard M. Novak, Gabriel J. Culbert, Aimee Wilkin, Libyadda J. Mosley, Nathan M. Thielman, J. Granholm, Victoria Watson, C. Clark, Joary Vargas Santana, I. Boneta, Indira Brar, Linda Makohon, Rodger D. MacArthur, Marti J. Farrough, M. Frank, Sarah J. Parker, Ellen Tedaldi, Mayra C. Santiago, Susan L. Koletar, Heather Harber, D. Thomas, Ioana Bica, Benjamin Adams, C. VAN DAM, Michael A. Kolber, Karen Moreno, Amanda Brown, B Wade
Formato: Artículo
Lenguaje:inglés
Publicado: 2023
Materias:
Medicine
COPD
Fibrinogen
Internal medicine
Spirometry
Immunology
Lung
Inflammation
Gastroenterology
Etiology
Asthma
Humans
Biomarkers
HIV Infections complications
HIV Infections drug therapy
Pulmonary Disease, Chronic Obstructive
Health Sciences Medicine Epidemiology Pneumocystis jirovecii pneumonia detection and treatment
Health Sciences Medicine Emergency Medicine HIV-related health complications and treatments
Health Sciences Medicine Public Health, Environmental and Occupational Health HIV/AIDS oral health manifestations
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Sumario:Abstract Chronic obstructive pulmonary disease (COPD) is among the leading causes of death worldwide and HIV is an independent risk factor for the development of COPD. However, the etiology of this increased risk and means to identify persons with HIV (PWH) at highest risk for COPD have remained elusive. Biomarkers may reveal etiologic pathways and allow better COPD risk stratification. We performed a matched case:control study of PWH in the Strategic Timing of Antiretoviral Treatment (START) pulmonary substudy. Cases had rapid lung function decline (> 40 mL/year FEV 1 decline) and controls had stable lung function (+ 20 to − 20 mL/year). The analysis was performed in two distinct groups: (1) those who were virally suppressed for at least 6 months and (2) those with untreated HIV (from the START deferred treatment arm). We used linear mixed effects models to test the relationship between case:control status and blood concentrations of pneumoproteins (surfactant protein-D and club cell secretory protein), and biomarkers of inflammation (IL-6 and hsCRP) and coagulation (d-dimer and fibrinogen); concentrations were measured within ± 6 months of first included spirometry. We included an interaction with treatment group (untreated HIV vs viral suppression) to test if associations varied by treatment group. This analysis included 77 matched case:control pairs in the virally suppressed batch, and 42 matched case:control pairs in the untreated HIV batch (n = 238 total) who were followed for a median of 3 years. Median (IQR) CD4 + count was lowest in the controls with untreated HIV at 674 (580, 838). We found no significant associations between case:control status and pneumoprotein or biomarker concentrations in either virally suppressed or untreated PWH. In this cohort of relatively young, recently diagnosed PWH, concentrations of pneumoproteins and biomarkers of inflammation and coagulation were not associated with subsequent rapid lung function decline. Trial registration: NCT00867048 and NCT01797367.

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