Imperial College London
Alternate

Emeritus ProfessorMyraMcClure

Faculty of Medicine, Department of Infectious Disease

Emeritus Professor of Retrovirology
 
 
 
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Contact

 

+44 (0)20 7594 3902m.mcclure

 
 
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Location

 

456Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Hamlyn:2015:10.1097/QAD.0000000000000675,
author = {Hamlyn, E and Stoehr, W and Cooper, DA and Fisher, M and Tambussi, G and Schechter, M and Miro, JM and Vanobberghen, F and Babiker, A and Weber, J and Mcclure, M and Porter, K and Fidler, S},
doi = {10.1097/QAD.0000000000000675},
journal = {AIDS},
pages = {1355--1361},
title = {The effect of short-course antiretroviral therapy initiated in primary HIV-1 infection on interleukin-6 and D-dimer levels},
url = {http://dx.doi.org/10.1097/QAD.0000000000000675},
volume = {29},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: Interruption of antiretroviral therapy (ART) in chronic HIV disease is associated with increased mortality, predicted by elevations in interleukin-6 (IL-6) and D-dimer. The effect of ART interruption in primary HIV-1 infection on these biomarkers is unknown.Methods: Plasma samples from 200 HIV seroconverters enrolled in the Short Pulse Anti-Retroviral Therapy At HIV Seroconversion trial of deferred ART (standard of care) – 12 or 48 week ART (ART12 or ART48, respectively) – were analysed for IL-6 and D-dimer at weeks 0, 12, 16, 48, 52, 60 and 108 after randomization. Changes in log10 levels from weeks 0 to 12 were analysed using linear regression, as were changes from baseline to 4 weeks after stopping ART. Areas under the biomarker–time curves (AUC) to week 108 were adjusted for baseline values, and compared across all arms.Results: Median (inter-quartile range) baseline IL-6 and D-dimer were 1.45 (0.88, 2.41) pg/ml and 0.34 (0.20, 0.50) mg/l, respectively. At week 12, D-dimer levels were significantly lower among treated compared to untreated individuals (P < 0.001), whereas IL-6 levels were similar (P = 0.23). Within 4 weeks from stopping ART, IL-6 and D-dimer levels rose by 22 and 18%, reaching pre-ART levels. Over 108-week follow-up, there was no difference between arms in IL-6 AUC (P = 0.53), but D-dimer AUC was significantly lower for ART12 and ART48 compared to standard of care (overall P = 0.008).Conclusion: Stopping ART in primary HIV-1 infection leads to inflammatory biomarker rebound to pre-treatment levels. However, over 108-week follow-up, we found no evidence that biomarker levels were higher for those interrupting ART, compared to those remaining ART-naïve, and D-dimer levels were significantly lower.
AU  - Hamlyn,E
AU  - Stoehr,W
AU  - Cooper,DA
AU  - Fisher,M
AU  - Tambussi,G
AU  - Schechter,M
AU  - Miro,JM
AU  - Vanobberghen,F
AU  - Babiker,A
AU  - Weber,J
AU  - Mcclure,M
AU  - Porter,K
AU  - Fidler,S
DO  - 10.1097/QAD.0000000000000675
EP  - 1361
PY  - 2015///
SN  - 0269-9370
SP  - 1355
TI  - The effect of short-course antiretroviral therapy initiated in primary HIV-1 infection on interleukin-6 and D-dimer levels
T2  - AIDS
UR  - http://dx.doi.org/10.1097/QAD.0000000000000675
UR  - http://hdl.handle.net/10044/1/34369
VL  - 29
ER  -
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