PMID- 32761193
OWN - NLM
STAT- MEDLINE
DCOM- 20220210
LR  - 20220210
IS  - 1537-6613 (Electronic)
IS  - 0022-1899 (Print)
IS  - 0022-1899 (Linking)
VI  - 223
IP  - 7
DP  - 2021 Apr 8
TI  - An Inflammatory Composite Score Predicts Mycobacterial Immune Reconstitution 
      Inflammatory Syndrome in People with Advanced HIV: A Prospective International 
      Cohort Study.
PG  - 1275-1283
LID - 10.1093/infdis/jiaa484 [doi]
AB  - BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) is a common cause 
      of morbidity among people with human immunodeficiency virus (PWH) who initiate 
      antiretroviral therapy (ART) with severe lymphopenia. Easily accessible tools 
      that reliably predict emergence and elucidate pathogenesis of IRIS are needed to 
      facilitate improved clinical management. METHODS: Plasma levels of biomarkers 
      were measured before ART initiation in a large multinational cohort of ART-naive 
      PWH with severe immunosuppression (CD4+ count <100 cells/mm3) in United States, 
      Kenya, and Thailand. We performed a series of multiparametric analyses of 
      inflammatory and clinical biomarkers and developed a composite score merging 
      relevant biomarkers for use in a prediction model. RESULTS: We identified a 
      distinct baseline inflammatory profile and changes in inflammatory networks among 
      biomarkers in participants who subsequently developed mycobacterial or viral 
      IRIS. We also developed a composite score incorporating biomarkers associated 
      with IRIS (interleukin-6 [IL-6], IL-10, IL-27, sCD14, interferon-gamma, tumor 
      necrosis factor-alpha, hyaluronic acid, D-dimer, body mass index, and hemoglobin) 
      that accurately predicted mycobacterial IRIS and death in this cohort. 
      CONCLUSIONS: Systemic inflammatory profiles in PWH with severe immunosuppression 
      are predictive of IRIS. Composite scores for the prediction of mycobacterial IRIS 
      and death could be useful for risk stratification in PWH and lymphopenia 
      initiating ART. CLINICAL TRIALS REGISTRATION: NCT00286767.
CI  - (c) The Author(s) 2020. Published by Oxford University Press for the Infectious 
      Diseases Society of America. All rights reserved. For permissions, e-mail: 
      journals.permissions@oup.com.
FAU - Vinhaes, Caian L
AU  - Vinhaes CL
AD  - Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil.
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research Initiative, Salvador, Brazil.
AD  - Curso de Medicina, Faculdade de Tecnologia e Ciencias, Salvador, Brazil.
FAU - Sheikh, Virginia
AU  - Sheikh V
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, Maryland, USA.
FAU - Oliveira-de-Souza, Deivide
AU  - Oliveira-de-Souza D
AD  - Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil.
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research Initiative, Salvador, Brazil.
AD  - Curso de Medicina, Faculdade de Tecnologia e Ciencias, Salvador, Brazil.
FAU - Wang, Jing
AU  - Wang J
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, Maryland, USA.
FAU - Rupert, Adam
AU  - Rupert A
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, Maryland, USA.
FAU - Roby, Gregg
AU  - Roby G
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, Maryland, USA.
FAU - Arriaga, Maria B
AU  - Arriaga MB
AD  - Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil.
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research Initiative, Salvador, Brazil.
AD  - Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
FAU - Fukutani, Kiyoshi F
AU  - Fukutani KF
AD  - Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil.
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research Initiative, Salvador, Brazil.
FAU - Sawe, Fred
AU  - Sawe F
AD  - Kenya Medical Research Institute, Henry Jackson Foundation Medical Research 
      International, Bethesda, Maryland, USA.
FAU - Shaffer, Doug
AU  - Shaffer D
AD  - Kenya Medical Research Institute, Henry Jackson Foundation Medical Research 
      International, Bethesda, Maryland, USA.
FAU - Ananworanich, Jintanat
AU  - Ananworanich J
AD  - South East Asia Research Collaboration with Hawaii, Henry M. Jackson Foundation 
      for the Advancement of Military Medicine, United States Military HIV Research 
      Program, Bethesda, Maryland, USA.
FAU - Phanuphak, Nittaya
AU  - Phanuphak N
AD  - Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
FAU - Andrade, Bruno B
AU  - Andrade BB
AD  - Instituto Goncalo Moniz, Fundacao Oswaldo Cruz, Salvador, Brazil.
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research Initiative, Salvador, Brazil.
AD  - Curso de Medicina, Faculdade de Tecnologia e Ciencias, Salvador, Brazil.
AD  - Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil.
AD  - Universidade Salvador, Laureate Universities, Salvador, Brazil.
AD  - Wellcome Centre for Infectious Disease Research in Africa, Institute of 
      Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 
      South Africa.
FAU - Sereti, Irini
AU  - Sereti I
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, Maryland, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT00286767
GR  - U01 AI069923/AI/NIAID NIH HHS/United States
GR  - U01 AI115940/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Infect Dis
JT  - The Journal of infectious diseases
JID - 0413675
RN  - 0 (Biomarkers)
SB  - IM
MH  - Biomarkers
MH  - *HIV Infections/complications/drug therapy
MH  - Humans
MH  - *Immune Reconstitution Inflammatory Syndrome/microbiology
MH  - *Lymphopenia
MH  - Prospective Studies
PMC - PMC8030712
OTO - NOTNLM
OT  - HIV
OT  - biomarkers
OT  - immune reconstitution inflammatory syndrome (IRIS)
OT  - tuberculosis
EDAT- 2020/08/08 06:00
MHDA- 2022/02/11 06:00
PMCR- 2021/08/06
CRDT- 2020/08/08 06:00
PHST- 2020/06/02 00:00 [received]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/08/08 06:00 [pubmed]
PHST- 2022/02/11 06:00 [medline]
PHST- 2020/08/08 06:00 [entrez]
PHST- 2021/08/06 00:00 [pmc-release]
AID - 5881925 [pii]
AID - jiaa484 [pii]
AID - 10.1093/infdis/jiaa484 [doi]
PST - ppublish
SO  - J Infect Dis. 2021 Apr 8;223(7):1275-1283. doi: 10.1093/infdis/jiaa484.