Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
National Institute of Allergy and Infectious Diseases (NIAID) - Tuesday, October 21, 2008
Media Contact: Laura Sivitz, (301) 402-1663, sivitzl@niaid.nih.gov
The new report, published in the open access journal PLoS Medicine, is a further analysis of the "Strategies for Management of Antiretroviral Therapy" (SMART) study supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. SMART, which ended in 2006, compared the standard practice of continuous ART to suppress HIV in infected individuals with episodic ART based on CD4+ T-cell counts. The goal was to determine whether reducing exposure to antiretroviral drugs, which may have toxic side effects and can engender drug resistance, would be equally or more beneficial than suppressing HIV continuously. Unexpectedly, those who received episodic ART were more than twice as likely to develop disease or die, and the study ended early as a result.
Reflecting on this outcome, James D. Neaton, Ph.D., of the University of Minnesota, and his colleagues hypothesized that pausing ART and allowing HIV levels to rise stimulated inflammation and blood clotting in some patients, which could lead to disease or death.
To test their hypothesis, the scientists examined blood samples from the SMART trial for proteins that are biological markers of inflammation and blood clotting. They found that people who began the study with relatively higher levels of the biomarkers interleukin-6 (IL-6) and D-dimer were at greater risk of death than other study participants. They also found that IL-6 and D-dimer levels rose significantly in the intermittent-treatment group compared to the continuous treatment group after just one month of study.
Based on these observations, the authors conclude that HIV-infected patients who have relatively high levels of IL-6 and D-dimer are at greater risk of death. Most of the deaths in SMART were attributed to non-AIDS-related diseases, the authors write, and giving intermittent ART to volunteers who began that study with elevated levels of these biomarkers may have further increased their risk of death.
Article: LH Kuller et al. Inflammatory and coagulation biomarkers and mortality in patients with HIV infection. PLoS Medicine DOI:10.1371/journal.pmed.0050203 (2008).
Who:
Anthony S. Fauci, M.D., the director of NIAID, and Karin L. Klingman, M.D., a medical officer in the NIAID Division of AIDS, are available for interviews.
Contact:
To schedule an interview with Dr. Fauci or Dr. Klingman, please contact Laura Sivitz, 301-402-1663, sivitzl@niaid.nih.gov.
NIAID conducts and supports research--at NIH, throughout the United States, and worldwide--to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov.
The National Institutes of Health (NIH)--The Nation's Medical Research Agency--includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.
081021
NIH081004
Published 2008 - National Institute of Allergy and Infectious Diseases . All material contained in this report is in the public domain and may be used and reprinted without special permission; citation to source, however, is appreciated.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, the Elton John AIDS Foundation, National Library of Medicine, and donations from users like you.
Always watch for outdated information. This article first appeared in 2008. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2008. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .