Markers of Inflammation and Immune Dysfunction and Non-AIDS Cancer Risk in Adults With HIV

Fecha de publicación: 01/01/2025

Autores de IIS La Fe

Marta Montero Alonso

Autor

Participantes ajenos a IIS La Fe

Izquierdo R.
Vallejo A.
Suárez-Garca I.
Martn-Hondarza A.
Gutierrez F.
Perez-Molina J.A.
Vinuesa Garca D.
MacAs J.
Rivero A.
Olalla J.
Asensi V.
Moreno S.
Jarrn I.
Rava M.

Grupos

Investigacion clínica en enfermedades crónicas e Infección por el VIH

Abstract

Introduction:We evaluated the association between pre-antiretroviral therapy (pre-ART) immune dysfunction and inflammation markers and the risk of non-AIDS cancer (NAC) in people with HIV after starting ART.Methods:In a case-cohort study nested within CoRIS, a cohort of ART-naive people with HIV who started ART during 2004-2020, we included 113 NAC cases and a random subcohort of 512 individuals without prior cancers and with at least 1 pre-ART blood sample. We assessed immune dysfunction (CD4+ and CD8+ cell count, CD4/CD8 ratio) and inflammation markers (interleukin-6 [IL-6], high-sensitivity C-reactive protein, D-Dimer, and soluble CD14). We estimated hazard ratios (HRs) for the association between markers quartiles and NAC risk using Prentice-weighted Cox models separately for each marker and including all markers simultaneously.Results:Among 614 participants (87.1% men; median age 37.3 years; 23.8% with CD4+ =500 cells/µL), we observed that NAC risk was not associated with immune dysfunction markers, and it was positively associated with IL-6 and D-dimer. Adjusted HRs for IL-6 ranged from 1.77 (95% confidence interval [CI]: 0.75 to 4.16) to 2.73 (1.09 to 6.86), while HRs for D-dimer were 3.93 (1.75, 8.84) for the third and 2.94 (1.26, 6.86) for the fourth compared with the first quartile. When all markers were included, only D-dimer confirmed its association with NAC.Conclusions:Pre-ART inflammation and altered coagulation, but not immune dysfunction markers, were associated with risk of NAC. Limitations include the low number of cancer cases, precluding cancer-specific analyses, and lack of information on relevant confounders, such as oncogenic coinfections. Further research is needed to validate these findings. © 2025 Wolters Kluwer Health. All rights reserved.

Datos de la publicación

ISSN/ISSNe:: 1525-4135, 1077-9450
Tipo:: Article
Páginas:: 274-282
DOI:: 10.1097/QAI.0000000000003667
PubMed:: 40192742
Enlace a otro recurso:: www.scopus.com
Factor de Impacto:: 1,469 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Izquierdo R.:: National Centre for Epidemiology, Carlos III Health Institute, Madrid, Spain

CIBERINFEC, Carlos III Health Institute, Madrid, Spain
Vallejo A.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Molecular Immunovirology Laboratory, Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain

Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain
Suárez-Garca I.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Infectious Diseases Group, Internal Medicine Service, Infanta Sofa University Hospital, Fiib Huis Hhen, Madrid, Spain
Martn-Hondarza A.:: Molecular Immunovirology Laboratory, Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain

Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain
Gutierrez F.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Hospital General Universitario de Elche, Universidad Miguel Hernández, Alicante, Spain
Perez-Molina J.A.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Molecular Immunovirology Laboratory, Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain

Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain
Vinuesa Garca D.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Infectious Diseases Unit, Clinical University Hospital San Cecilio, Granada, Spain
MacAs J.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Department of Medicine, IBiS, University of Seville. Virgen de Valme University Hospital, Seville, Spain
Rivero A.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Department of Infectious Diseases, University of Córdoba, Reina Sofa University Hospital, Clinical Virology and Zoonoses Research Group, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
Olalla J.:: Internal Medicine Service, Costa Del Sol University Hospital, Marbella, Spain
Montero-Alonso M.:: Infectious Diseases Unit, La Fe University and Polytechnic Hospital, Valencia, Spain
Asensi V.:: Infectious Diseases Unit, Central University Hospital of Asturias and Group of Translational Research in Infectious Diseases, Health Research Institute of the Principality of Asturias (ISPA) Oviedo, Spain
Moreno S.:: CIBERINFEC, Carlos III Health Institute, Madrid, Spain

Department of Infectious Diseases, Health Research Institute Ramón y Cajal (IRYCIS), University Hospital Ramón y Cajal, Madrid, Spain

Alcalá University, Madrid, Spain
Jarrn I.:: National Centre for Epidemiology, Carlos III Health Institute, Madrid, Spain
Rava M.:: National Centre for Epidemiology, Carlos III Health Institute, Madrid, Spain

Keywords

antiretrovirus agent; biological marker; C reactive protein; CD14 antigen; CD4 antigen; CD8 antigen; D dimer; interleukin 6; adult; antiretroviral therapy; Article; blood clotting; cancer risk; CD4 CD8 ratio; CD4 lymphocyte count; CD8 lymphocyte count; cohort analysis; controlled study; female; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; immune dysregulation; inflammation; major clinical study; male

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