dc.contributor.author | Musinguzi, Nicholas | |
dc.contributor.author | Jose, Castillo-Mancilla | |
dc.contributor.author | Morrow, Mary | |
dc.contributor.author | Byakwaga, Helen | |
dc.contributor.author | Mawhinney, Samantha | |
dc.contributor.author | Burdo, Tricia H. | |
dc.contributor.author | Boum, Yap | |
dc.contributor.author | Muzoora, Conrad | |
dc.contributor.author | Bwana, Bosco M. | |
dc.contributor.author | Siedner, Mark J. | |
dc.contributor.author | Martin, Jeffrey N. | |
dc.contributor.author | Hunt, Peter W. | |
dc.contributor.author | Bangsberg, David R. | |
dc.contributor.author | Haberer, Jessica E. | |
dc.date.accessioned | 2022-06-13T09:28:19Z | |
dc.date.available | 2022-06-13T09:28:19Z | |
dc.date.issued | 2019 | |
dc.identifier.citation | Musinguzi, N., Jose, C. M., Morrow, M., Byakwaga, H., Mawhinney, S., Burdo, T. H., ... & Haberer, J. E. (2019). Antiretroviral therapy adherence interruptions are associated with systemic inflammation among Ugandans who achieved viral suppression. Journal of acquired immune deficiency syndromes (1999), 82(4), 386. | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/2097 | |
dc.description.abstract | Background: Residual systemic inflammation, which is associated with non-AIDS clinical outcomes, may persist despite viral suppression. We assessed the effect of antiretroviral (ART) adherence interruptions on systemic inflammation among Ugandans living with HIV who were virally suppressed.
Setting; We evaluated adults initiating first-line ART at a regional referral hospital clinic in Mbarara, Uganda.
Methods: Plasma concentrations of interleukin-6 (IL-6), D-dimer, soluble sCD14, sCD163, the kynurenine/tryptophan (K/T) ratio, and CD8+ T-cell activation (HLA-DR+/CD38+ co-expression) were measured at baseline and 6 months following ART initiation among participants who achieved viral suppression (VL<400) at 6 months. ART adherence was monitored electronically. Time spent in an adherence interruption was computed as the percentage of days when the running average adherence was ≥10%. We fit adjusted linear regressions to evaluate the effect of time spent in an interruption on the log-transformed plasma concentrations of the inflammation biomarkers.
Results: Of 282 participants, 70% were female and median age was 34 years. At baseline, median CD4 and median log viral load were 135 cells/μl and 5.1 copies/ml, respectively. In the adjusted analysis, a running average adherence <10% was associated with higher sCD14 (+3%, p<0.008), sCD163 (+5%, p=0.002), D-dimer (+10%, p=0.007), HLA-DR+/CD8+ (+3%, p<0.025), IL-6 (+14%, p=0.008), and K: T ratio (+5%, p=0.002). These findings were largely robust to adjustment for average adherence, as well as higher thresholds of running average adherence, albeit with decreased statistical significance.
Conclusion: Increased time spent in adherence interruptions is associated with increased levels of inflammation despite viral suppression above and beyond average adherence. | en_US |
dc.description.sponsorship | U.S. National Institutes of Health (NIH) R01 MH54907, P30 AI27763, UM1 CA181255 | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | Journal of acquired immune deficiency syndromes | en_US |
dc.subject | Adherence | en_US |
dc.subject | Treatment interruption | en_US |
dc.subject | Inflammation | en_US |
dc.subject | Antiretroviral therapy | en_US |
dc.subject | Uganda | en_US |
dc.title | Antiretroviral Therapy Adherence Interruptions are Associated with Systemic Inflammation among Ugandans who Achieved Viral Suppression | en_US |
dc.type | Article | en_US |