The University of Texas at Austin, School of Nursing, United States of America.
The University of Texas at Austin, College of Education, Department of Kinesiology and Health Education, United States of America.
Appl Nurs Res. 2020 Apr;52:151224. doi: 10.1016/j.apnr.2019.151224. Epub 2019 Dec 26.
Persons living with HIV experience high symptom burden that can negatively impact medication adherence, work productivity, and quality of life. Symptoms are highly subjective, which can lead to under- or improper treatment. The purpose of this exploratory study was to examine relationships between circulating biomarkers representative of inflammatory, coagulation, and vascular function pathways and prevalent HIV symptoms.
Adults >18 years who were diagnosed with HIV and spoke English for this cross-sectional study were recruited from community clinics and organizations.
Symptom burden was measured with the HIV Symptom Index; depression with the Patient Health Questionnaire. Human multiplex kits were used to determine serum concentrations of select biomarkers representing inflammatory, coagulation, and vascular function pathways. The biomarkers were included as features in machine learning models to determine which biomarkers predicted the most prevalent HIV symptoms (fatigue and muscle/joint pain) and the symptom of depression.
Participants (N = 32) were representative of the local population of people with HIV, being mostly Black (54.4%) and male (60.6%). Depression was predicted by age, gender, glucose, hemoglobin A1c, and inflammation. Muscle/joint pain was predicted by adiponectin, C-reactive protein, and serum amyloid A (SAA). Fatigue was predicted by adiponectin, SAA, and soluble interleukin-1 receptor type II (sIL-1RII).
Biomarker clusters can be a tool to monitor symptoms. Adding an objective measure to subjective patient experiences could improve management and monitoring of symptoms. Defining a biomarker cluster for the objective assessment of HIV symptoms warrants further investigation; however, the presence of comorbid conditions needs to be controlled.
感染艾滋病毒的人会经历较高的症状负担，这可能会对药物依从性、工作效率和生活质量产生负面影响。症状具有高度主观性，这可能导致治疗不足或不当。本探索性研究的目的是检查代表炎症、凝血和血管功能途径的循环生物标志物与常见艾滋病毒症状之间的关系。
这项横断面研究招募了年龄在 18 岁及以上、被诊断患有艾滋病毒且会说英语的成年人，他们来自社区诊所和组织。
用艾滋病毒症状指数测量症状负担；用患者健康问卷测量抑郁情况。使用人类多重试剂盒来确定代表炎症、凝血和血管功能途径的选定生物标志物的血清浓度。将这些生物标志物作为特征纳入机器学习模型中，以确定哪些生物标志物预测最常见的艾滋病毒症状（疲劳和肌肉/关节疼痛）和抑郁症状。
参与者（N=32）具有艾滋病毒患者的当地人群代表性，主要为黑人（54.4%）和男性（60.6%）。抑郁由年龄、性别、葡萄糖、糖化血红蛋白和炎症预测。肌肉/关节疼痛由脂联素、C 反应蛋白和血清淀粉样蛋白 A（SAA）预测。疲劳由脂联素、SAA 和可溶性白细胞介素 1 受体 II 型（sIL-1RII）预测。
生物标志物聚类可以作为监测症状的一种工具。将客观的测量方法添加到主观的患者体验中可以改善症状的管理和监测。定义用于客观评估艾滋病毒症状的生物标志物聚类需要进一步研究；但是，需要控制合并症的存在。
