Endothelial activation biomarkers increase after HIV-1 acquisition: Plasma vascular cell adhesion molecule-1 predicts disease progression

摘要

OBJECTIVE: We aimed to determine whether endothelial activation biomarkers increase after HIV-1 acquisition, and whether biomarker levels measured in chronic infection would predict disease progression and death in HIV-1 seroconverters. DESIGN: HIV-1-seronegative Kenyan women were monitored monthly for seroconversion, and followed prospectively after HIV-1 acquisition. METHODS: Plasma levels of angiopoietin-1 and angiopoietin-2 (ANG-1, ANG-2) and soluble vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin were tested in stored samples from pre-infection, acute infection, and two chronic infection time points. We used nonparametric tests to compare biomarkers before and after HIV-1 acquisition, and Cox proportional-hazards regression to analyze associations with disease progression (CD4 <200a??cells/μl, stage IV disease, or antiretroviral therapy initiation) or death. RESULTS: Soluble ICAM-1 and VCAM-1 were elevated relative to baseline in all postinfection periods assessed (Pa??