Castillo-Mancilla Jose R, Phillips Andrew N, Neaton James D, Neuhaus Jacqueline, Collins Simon, Mannheimer Sharon, Pett Sarah, Touzeau-Römer Veronique, Polizzotto Mark N, Lundgren Jens D, Gardner Edward M
University of Colorado-AMC, Medicine/Infectious Diseases, Aurora, Colorado.
Institute for Global Health, University College London, London, UK.
Open Forum Infect Dis. 2017 Dec 22;5(1):ofx275. doi: 10.1093/ofid/ofx275. eCollection 2018 Jan.
Suboptimal (ie, <100%) antiretroviral therapy (ART) adherence has been associated with heightened inflammation in cohort studies, even among people with virologic suppression. We aimed to evaluate this association among participants in the Strategies for Management of Antiretroviral Therapy (SMART) study who had virologic suppression (HIV-1 VL < 200 copies/mL) at enrollment. Based on self-reported adherence (7-day recall), plasma concentrations of interleukin 6 and D-dimer were 9% (95% confidence interval [CI], 1%-18%; = .02) and 11% (95% CI, 1%-22%; = .03) higher in participants who reported suboptimal vs 100% adherence, respectively. These findings confirm previous observations and support the hypothesis that suboptimal ART adherence, even in the context of virologic suppression, may have significant biological consequences. ClinicalTrials.gov number NCT00027352.
在队列研究中,抗逆转录病毒疗法(ART)依从性欠佳(即<100%)与炎症加剧有关,即使在病毒学抑制的人群中也是如此。我们旨在评估抗逆转录病毒治疗管理策略(SMART)研究中入组时病毒学抑制(HIV-1病毒载量<200拷贝/毫升)的参与者之间的这种关联。根据自我报告的依从性(7天回忆法),报告依从性欠佳与100%依从性的参与者相比,白细胞介素6和D-二聚体的血浆浓度分别高出9%(95%置信区间[CI],1%-18%;P = .02)和11%(95%CI,1%-22%;P = .03)。这些发现证实了先前的观察结果,并支持以下假设:即使在病毒学抑制的情况下,ART依从性欠佳也可能产生重大生物学后果。ClinicalTrials.gov编号NCT00027352。