Lacerda Heloísa Ramos, Falcão Maria da Conceição Correia, de Albuquerque Valéria Maria Gonçalves, Zírpoli Josefina Claudia, Miranda-Filho Demócrito de Barros, de Albuquerque Maria de Fátima Pessoa Militão, Montarroyos Ulisses, Ximenes Ricardo Arraes de Alencar
1 Postgraduate Program on Tropical Medicine, Federal University of Pernambuco , Recife, Brazil .
J Interferon Cytokine Res. 2014 May;34(5):385-93. doi: 10.1089/jir.2013.0029. Epub 2013 Dec 20.
Elevated levels of inflammatory and endothelial biomarkers are related to chronic diseases, cancers, and cardiovascular disease. This study aimed at evaluating the association of inflammatory cytokines and endothelial adhesion molecules with immunological, virological, and cardiometabolic disease in HIV-infected individuals. A cross-sectional study was initiated to evaluate the association of CD4 lymphocyte count, viral load, antiretroviral therapy, and metabolic and cardiovascular disease with inflammatory cytokines [interleukin (IL)-1β, IL-6, and tumor necrosis factor α (TNF-α)], adhesion molecules [soluble intercellular Adhesion Molecule 1 (sICAM) and soluble Vascular Adhesion Molecule 1 (sVCAM)], and highsensitive C-reactive protein (hs-CRP) levels in 125 HIV-infected patients. The associations between independent variables and biomarkers were analyzed by means of multivariate logistic regression. A viral load ≥100,000 copies/mL had a stronger association with high levels of sVCAM-1 (P=0.026; OR=2.54; CI=1.12-5.78) and TNF-α (P=0.048; OR=2.42; CI=1.01-5.85) than the current viral load using a multivariate analysis. Antiretroviral treatment was associated with lower levels of sVCAM-1 (P=0.20; OR=0.20; CI=0.05-0.78), TNF-α (P=0.060; OR=0.22; CI=0.05-1.07), and hs-CRP (P=0.093; OR=0.44; CI=0.17-1.15). CD4 counts <200 cells/mm(3) were associated with high IL-6 levels (P=0.013; OR=3.17; CI=1.27-7.91); however, antiretroviral treatment was not associated with IL-6 levels. Metabolic syndrome was associated with high hs-CRP levels, systolic hypertension was associated with IL-6 levels, and family history of coronary disease was associated with TNF-α levels. High biomarker levels were associated not only with viral and immunological characteristics but also with cardiometabolic factors. The maximum viral load attained was an important risk factor for high levels of TNF-α and sVCAM-1. Treatment protected patients from high biomarker levels, except IL-6.
炎症和内皮生物标志物水平升高与慢性疾病、癌症及心血管疾病相关。本研究旨在评估炎症细胞因子和内皮黏附分子与HIV感染个体的免疫、病毒学及心脏代谢疾病之间的关联。启动了一项横断面研究,以评估125例HIV感染患者的CD4淋巴细胞计数、病毒载量、抗逆转录病毒治疗以及代谢和心血管疾病与炎症细胞因子[白细胞介素(IL)-1β、IL-6和肿瘤坏死因子α(TNF-α)]、黏附分子[可溶性细胞间黏附分子1(sICAM)和可溶性血管黏附分子1(sVCAM)]以及高敏C反应蛋白(hs-CRP)水平之间的关联。通过多因素逻辑回归分析自变量与生物标志物之间的关联。多因素分析显示,病毒载量≥100,000拷贝/mL与高水平的sVCAM-1(P=0.026;OR=2.54;CI=1.12-5.78)和TNF-α(P=0.048;OR=2.42;CI=1.01-5.85)的关联比当前病毒载量更强。抗逆转录病毒治疗与较低水平的sVCAM-1(P=0.20;OR=0.20;CI=0.05-0.78)、TNF-α(P=0.060;OR=0.22;CI=0.05-1.07)和hs-CRP(P=0.093;OR=0.44;CI=0.17-1.15)相关。CD4计数<200个细胞/mm³与高水平的IL-6相关(P=0.013;OR=3.17;CI=1.27-7.91);然而,抗逆转录病毒治疗与IL-6水平无关。代谢综合征与高水平的hs-CRP相关,收缩期高血压与IL-6水平相关,冠心病家族史与TNF-α水平相关。高生物标志物水平不仅与病毒和免疫特征相关,还与心脏代谢因素相关。达到的最高病毒载量是高水平TNF-α和sVCAM-1的重要危险因素。除IL-6外,治疗可使患者免受高生物标志物水平的影响。