Immunologic biomarkers, morbidity, and mortality in treated HIV infection

PW Hunt, SA Lee, MJ Siedner - The Journal of infectious …, 2016 - academic.oup.com
The Journal of infectious diseases, 2016academic.oup.com
Despite marked improvements in the modern treatment era, human immunodeficiency virus
(HIV)–infected individuals, particularly those who initiated antiretroviral therapy (ART) at
advanced disease stages, continue to have increased age-related morbidity and mortality,
compared with the general population. Immune activation and inflammation persist despite
suppressive ART and predict many of these morbidities. The goal of this review is to
examine the evidence suggesting a link between the persistent inflammatory state and …
Abstract
Despite marked improvements in the modern treatment era, human immunodeficiency virus (HIV)–infected individuals, particularly those who initiated antiretroviral therapy (ART) at advanced disease stages, continue to have increased age-related morbidity and mortality, compared with the general population. Immune activation and inflammation persist despite suppressive ART and predict many of these morbidities. The goal of this review is to examine the evidence suggesting a link between the persistent inflammatory state and morbidity and mortality in this setting, to describe the impact of early ART initiation on these factors, and to highlight important unanswered questions for the field. We also advance a hypothesis to explain why some morbidities—and their root inflammatory drivers—may be prevented more than others by early ART initiation.
Oxford University Press