Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin OH-43016, United States.
Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Legon, Ghana.
Curr HIV Res. 2020;18(6):466-474. doi: 10.2174/1570162X18666200817111152.
Studies from high-income countries have reported that even after receiving antiretroviral treatment (ART), HIV-infected adults may not achieve normal levels of certain inflammatory markers that are known to be associated with the onset and development of non-communicable diseases.
The aim of this study is to examine the relationship between ART and markers of systemic inflammation in HIV/AIDS patients at an urban antiretroviral clinic in Ghana.
We examined serum levels of high sensitivity CRP (hsCRP), interleukin-6 (IL-6), interleukin- 18(IL-18), and tumor necrosis factor-α (sTNFR1 and sTNFR2) from 40 HIV infected patients. Kruskal-Wallis Test was used to examine the differences in markers of systemic inflammation according to the types of ART medication taken. We then utilized generalized additive models (GAM) with non-linear function to examine the association between ART and markers of systemic inflammation after adjusting for potential confounders.
Overall, 30 (75.0%) of the participants received ART and 35 (85%) were female. Kruskal- Wallis Test revealed no significant differences in the markers of systemic inflammation among the three categories of ART (none, AZT, 3TC, EFV/NVP, and TDF, 3TC/FTC, EFV/NVP). In the multivariable- adjusted GAM model, we found a significant but non-linear association between time since diagnosis and CRP levels (p=0.006).
Although the relatively small sample size limits the scope of the study's findings, these results suggest that individuals on ART need to be screened periodically for the development of chronic conditions. This line of investigation has the potential to influence treatment and clinical guidelines that will improve the quality of care for HIV-infected patients.
来自高收入国家的研究报告称，即使接受了抗逆转录病毒治疗（ART），HIV 感染者的某些炎症标志物水平仍可能无法恢复正常，而这些标志物与非传染性疾病的发生和发展有关。
本研究旨在探讨加纳市一家抗逆转录病毒诊所中 HIV/AIDS 患者接受 ART 治疗与全身炎症标志物之间的关系。
我们检测了 40 名 HIV 感染患者的血清高敏 C 反应蛋白（hsCRP）、白细胞介素 6（IL-6）、白细胞介素 18（IL-18）和肿瘤坏死因子-α（sTNFR1 和 sTNFR2）水平。Kruskal-Wallis 检验用于检验根据所服用的 ART 药物类型，全身炎症标志物的差异。然后，我们利用广义加性模型（GAM）和非线性函数，在调整了潜在混杂因素后，检验了 ART 与全身炎症标志物之间的关联。
总体而言，30 名（75.0%）参与者接受了 ART 治疗，其中 35 名（85%）为女性。Kruskal-Wallis 检验显示，三种 ART 类别（无 ART、AZT、3TC、EFV/NVP 和 TDF、3TC/FTC、EFV/NVP）之间的全身炎症标志物无显著差异。在多变量调整的 GAM 模型中，我们发现 CRP 水平与诊断后时间之间存在显著的非线性关联（p=0.006）。
尽管样本量较小限制了研究结果的范围，但这些结果表明，接受 ART 治疗的个体需要定期筛查慢性疾病的发生。这一研究方向有可能影响治疗和临床指南，从而改善 HIV 感染者的护理质量。
