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Timing Of Antiretroviral Therapy And Systemic Inflammation In Sub-Saharan Africa: Results From The Meta Longitudinal Cohort Study, Mark J. Siedner, Bosco M. Bwana, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Jose R. Castillo-Mancilla, Russell P. Tracy, Ingrid T. Katz, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/ μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P < .05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P > .05), owing to loss from observation and greater declines in biomarkers in latestage initiators (P < .001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.