Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study
Abstract Background Various individual biomarkers of inflammation and micronutrient status, often correlated with each other, are associated with adverse treatment outcomes in human immunodeficiency virus (HIV)-infected adults. The objective of this study was to conduct exploratory factor analysis (...
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BMC
2018-09-01
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| Series: | BMC Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12916-018-1150-3 |
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| author | Rupak Shivakoti Nikhil Gupte Srikanth Tripathy Selvamuthu Poongulali Cecilia Kanyama Sima Berendes Sandra W. Cardoso Breno R. Santos Alberto La Rosa Noluthando Mwelase Sandy Pillay Wadzanai Samaneka Cynthia Riviere Patcharaphan Sugandhavesa Robert C. Bollinger Ashwin Balagopal Richard D. Semba Parul Christian Thomas B. Campbell Amita Gupta for the NWCS 319 and PEARLS Study Team |
| author_facet | Rupak Shivakoti Nikhil Gupte Srikanth Tripathy Selvamuthu Poongulali Cecilia Kanyama Sima Berendes Sandra W. Cardoso Breno R. Santos Alberto La Rosa Noluthando Mwelase Sandy Pillay Wadzanai Samaneka Cynthia Riviere Patcharaphan Sugandhavesa Robert C. Bollinger Ashwin Balagopal Richard D. Semba Parul Christian Thomas B. Campbell Amita Gupta for the NWCS 319 and PEARLS Study Team |
| author_sort | Rupak Shivakoti |
| collection | DOAJ |
| description | Abstract Background Various individual biomarkers of inflammation and micronutrient status, often correlated with each other, are associated with adverse treatment outcomes in human immunodeficiency virus (HIV)-infected adults. The objective of this study was to conduct exploratory factor analysis (EFA) on multiple inflammation and micronutrient biomarkers to identify biomarker groupings (factors) and determine their association with HIV clinical treatment failure (CTF) and incident active tuberculosis (TB). Methods Within a multicountry randomized trial of antiretroviral therapy (ART) efficacy (PEARLS) among HIV-infected adults, we nested a case-control study (n = 290; 124 cases, 166 controls) to identify underlying factors, based on EFA of 23 baseline (pre-ART) biomarkers of inflammation and micronutrient status. The EFA biomarker groupings results were used in Cox proportional hazards models to study the association with CTF (primary analysis where cases were incident World Health Organization stage 3, 4 or death by 96 weeks of ART) or incident active TB (secondary analysis). Results In the primary analysis, based on eigenvalues> 1 in the EFA, three factors were extracted: (1) carotenoids), (2) other nutrients, and (3) inflammation. In multivariable-adjusted models, there was an increased hazard of CTF (adjusted hazard ratio (aHR) 1.47, 95% confidence interval (CI)1.17–1.84) per unit increase of inflammation factor score. In the secondary incident active TB case-control analysis, higher scores of the high carotenoids and low interleukin-18 factor was protective against incident active TB (aHR 0.48, 95% CI 0.26–0.87). Conclusion Factors identified through EFA were associated with adverse outcomes in HIV-infected individuals. Strategies focused on reducing adverse HIV outcomes through therapeutic interventions that target the underlying factor (e.g., inflammation) rather than focusing on an individual observed biomarker might be more effective and warrant further investigation. |
| first_indexed | 2024-12-11T06:20:33Z |
| format | Article |
| id | doaj.art-727a2d4c6dea442f907e6a1fab73b79a |
| institution | Directory Open Access Journal |
| issn | 1741-7015 |
| language | English |
| last_indexed | 2024-12-11T06:20:33Z |
| publishDate | 2018-09-01 |
| publisher | BMC |
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| series | BMC Medicine |
| spelling | doaj.art-727a2d4c6dea442f907e6a1fab73b79a2022-12-22T01:17:50ZengBMCBMC Medicine1741-70152018-09-011611910.1186/s12916-018-1150-3Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control studyRupak Shivakoti0Nikhil Gupte1Srikanth Tripathy2Selvamuthu Poongulali3Cecilia Kanyama4Sima Berendes5Sandra W. Cardoso6Breno R. Santos7Alberto La Rosa8Noluthando Mwelase9Sandy Pillay10Wadzanai Samaneka11Cynthia Riviere12Patcharaphan Sugandhavesa13Robert C. Bollinger14Ashwin Balagopal15Richard D. Semba16Parul Christian17Thomas B. Campbell18Amita Gupta19for the NWCS 319 and PEARLS Study TeamDepartment of Medicine, Johns Hopkins University School of MedicineDepartment of Medicine, Johns Hopkins University School of MedicineNational AIDS Research InstituteYR Gaitonde Center for AIDS Research and EducationUNC LilongweMalawi College of Medicine-Johns Hopkins University Research ProjectSTD/AIDS Clinical Research Laboratory, Instituto de Pesquisa Clinica Evandro Chagas, Fundacao Oswaldo CruzHospital Nossa Senhora de ConceiçãAsociacion Civil Impacta Salud y EducacionDepartment of Medicine, University of WitwatersrandDurban International Clinical Research Site, Durban University of TechnologyUniversity of Zimbabwe Clinical Research CentreLes Centres GHESKIOResearch Institute for Health SciencesDepartment of Medicine, Johns Hopkins University School of MedicineDepartment of Medicine, Johns Hopkins University School of MedicineDepartment of Ophthalmology, Johns Hopkins University School of MedicineDepartment of International Health, Johns Hopkins Bloomberg School of Public HealthDepartment of Medicine, Division of Infectious Diseases, University of Colorado School of MedicineDepartment of Medicine, Johns Hopkins University School of MedicineAbstract Background Various individual biomarkers of inflammation and micronutrient status, often correlated with each other, are associated with adverse treatment outcomes in human immunodeficiency virus (HIV)-infected adults. The objective of this study was to conduct exploratory factor analysis (EFA) on multiple inflammation and micronutrient biomarkers to identify biomarker groupings (factors) and determine their association with HIV clinical treatment failure (CTF) and incident active tuberculosis (TB). Methods Within a multicountry randomized trial of antiretroviral therapy (ART) efficacy (PEARLS) among HIV-infected adults, we nested a case-control study (n = 290; 124 cases, 166 controls) to identify underlying factors, based on EFA of 23 baseline (pre-ART) biomarkers of inflammation and micronutrient status. The EFA biomarker groupings results were used in Cox proportional hazards models to study the association with CTF (primary analysis where cases were incident World Health Organization stage 3, 4 or death by 96 weeks of ART) or incident active TB (secondary analysis). Results In the primary analysis, based on eigenvalues> 1 in the EFA, three factors were extracted: (1) carotenoids), (2) other nutrients, and (3) inflammation. In multivariable-adjusted models, there was an increased hazard of CTF (adjusted hazard ratio (aHR) 1.47, 95% confidence interval (CI)1.17–1.84) per unit increase of inflammation factor score. In the secondary incident active TB case-control analysis, higher scores of the high carotenoids and low interleukin-18 factor was protective against incident active TB (aHR 0.48, 95% CI 0.26–0.87). Conclusion Factors identified through EFA were associated with adverse outcomes in HIV-infected individuals. Strategies focused on reducing adverse HIV outcomes through therapeutic interventions that target the underlying factor (e.g., inflammation) rather than focusing on an individual observed biomarker might be more effective and warrant further investigation.http://link.springer.com/article/10.1186/s12916-018-1150-3HIVInflammationAntiretroviral therapyTuberculosisIL-18Exploratory factor analysis |
| spellingShingle | Rupak Shivakoti Nikhil Gupte Srikanth Tripathy Selvamuthu Poongulali Cecilia Kanyama Sima Berendes Sandra W. Cardoso Breno R. Santos Alberto La Rosa Noluthando Mwelase Sandy Pillay Wadzanai Samaneka Cynthia Riviere Patcharaphan Sugandhavesa Robert C. Bollinger Ashwin Balagopal Richard D. Semba Parul Christian Thomas B. Campbell Amita Gupta for the NWCS 319 and PEARLS Study Team Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study BMC Medicine HIV Inflammation Antiretroviral therapy Tuberculosis IL-18 Exploratory factor analysis |
| title | Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study |
| title_full | Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study |
| title_fullStr | Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study |
| title_full_unstemmed | Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study |
| title_short | Inflammation and micronutrient biomarkers predict clinical HIV treatment failure and incident active TB in HIV-infected adults: a case-control study |
| title_sort | inflammation and micronutrient biomarkers predict clinical hiv treatment failure and incident active tb in hiv infected adults a case control study |
| topic | HIV Inflammation Antiretroviral therapy Tuberculosis IL-18 Exploratory factor analysis |
| url | http://link.springer.com/article/10.1186/s12916-018-1150-3 |
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