Plasma sVCAM‐1, antiretroviral therapy and mortality in HIV‐1‐infected West African adults

• Published in: HIV medicine 2022-08, Vol.23 (7), p.717-726
• Main Authors: Affi, Roseline, Gabillard, Delphine, Kouame, Gérard Menan, Ntakpe, Jean Baptiste, Moh, Raoul, Badje, Anani, Danel, Christine, Inwoley, André, Eholié, Serge P., Anglaret, Xavier, Weiss, Laurence
• Format: Article
• Language: English
• Subjects: Adults; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; CD4 antigen; Cell adhesion; Cell adhesion molecules; Confidence intervals; Death; Drug therapy; endothelial dysfunction; HIV; Human immunodeficiency virus; Life Sciences; Mortality; Peripheral blood; Risk analysis; Santé publique et épidémiologie; Sexually transmitted diseases; Statistical analysis; STD; sub‐Saharan Africa
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.13230

Objectives We report the association between pre‐antiretroviral therapy (pre‐ART) soluble vascular cell adhesion molecule‐1 (sVCAM‐1) levels and long‐term mortality in HIV‐infected West African adults participating in a trial of early ART in West Africa (Temprano ANRS 12136 trial). Methods The ART‐naïve HIV‐infected adults were randomly assigned to start ART immediately or defer ART until the WHO criteria were met. Participants who completed the trial follow‐up were invited to participate in a post‐trial phase (PTP). The PTP end‐point was all‐cause death. We used multivariable Cox proportional models to analyse the association between baseline sVCAM‐1 and all‐cause death, adjusting for ART strategy, sex, CD4 count, plasma HIV‐1 RNA and peripheral blood mononuclear cell HIV‐1 DNA levels. Results In all, 954 adults (77% women, median CD4 count of 387 cells/μL) were randomly assigned to start ART immediately (n = 477) or to defer initiation of ART (n = 477). They were followed for a median of 5.8 years [interquartile range (IQR): 5.2–6.3]. In multivariable analysis, the risk of death was significantly associated with baseline sVCAM‐1 [≥1458 vs.