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d-Dimer and CRP levels are elevated prior to antiretroviral treatment in patients who develop IRIS

2010; Elsevier BV; Volume: 136; Issue: 1 Linguagem: Inglês

10.1016/j.clim.2010.02.010

1521-7035

Brian Porter, G. Laïssa Ouedraogo, Jessica N. Hodge, Margo A. Smith, Alice K. Pau, Gregg Roby, Richard Kwan, Rachel Bishop, Catherine Rehm, JoAnn M. Mican, Irini Sereti,

Pneumocystis jirovecii pneumonia detection and treatment

Biomarkers could be useful in evaluating immune reconstitution inflammatory syndrome (IRIS). A cohort of 45 HIV-1-infected, antiretroviral treatment (ART)-naive patients with baseline CD4 T cell counts <or=100 cells/microL who were started on ART, suppressed HIV-RNA to <50 copies/mL, and seen every 1-3 months for 1 year were retrospectively evaluated for suspected or confirmed IRIS. d-Dimer, C-reactive protein (CRP), and selected autoantibodies were analyzed at baseline, 1 and 3 months post-ART in cryopreserved plasma. Median differences between cases and controls were compared with Mann-Whitney and Fisher's exact tests. Sixteen patients (35.6%) developed IRIS (median of 35 days post-ART initiation): unmasking=8, paradoxical=7, autoimmune=1. Pre-ART d-dimer and CRP were higher in IRIS cases versus controls (d-dimer: 0.89 mg/L versus 0.66 mg /L, p=0.037; CRP: 0.74 mg/L versus 0.39 mg/L, p=0.022), while d-dimer was higher in unmasking cases at IRIS onset (2.04 mg/L versus 0.36 mg /L, p=0.05). These biomarkers may be useful in identifying patients at risk for IRIS.