Changes in Urinary Biomarkers Over 10 Years Is Associated With Viral Suppression in a Prospective Cohort of Women Living With HIV
Year: 2016
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in 3 urine biomarkers over 10 years among women living with HIV. METHODS: Prospective cohort of 294 HIV-infected women from the multicenter Women's Interagency HIV Study. Predictors included HIV viral and immunological parameters, comorbid conditions, and health-related behaviors. Outcomes were patterns of changes of urine interleukin-18 (IL-18), albumin-to-creatinine ratio (ACR), and alpha-1-microglobulin (α1m) over 10 years. We used quantile regression to examine patterns of change in each urine biomarker during follow-up and multivariable analysis of variance regression to identify predictors of biomarker changes. RESULTS: Over 10 years, the median concentrations of IL-18 declined from 120 to 64 pg/mL, α1m rose from 0.7 to 1.5 ng/mL, and ACR remained stable (9-8 mg/g). In multivariate analyses, the strongest predictors of increases in IL-18 were higher baseline body mass index, increase in waist circumference, higher follow-up HIV viral load, lower follow-up CD4 cell count, hepatitis C virus (HCV) coinfection, and higher follow-up high density lipoprotein cholesterol. Predictors of increasing concentration of α1m were lower CD4 cell counts, higher diastolic blood pressure, HCV coinfection, and smoking. Finally, determinants of ACR increases during follow-up were higher follow-up diastolic blood pressure, HCV coinfection, higher follow-up HIV viral load, and triglyceride concentration. CONCLUSIONS: Over 10 years, HIV disease status had different associations with each urine biomarker under study. Overall, the associations with changes in each biomarker support research into their use for longitudinal monitoring of kidney health.
Authors: Sanjiv M. Baxi, Rebecca Scherzer, Vasantha Jotwani, Michelle M. Estrella, Alison G. Abraham, Chirag R. Parikh, Michael R. Bennett, Mardge H. Cohen, Marek J. Nowicki, Deborah R. Gustafson, Anjali Sharma, Mary A. Young, Michael G. Shlipak, for the Women's Interagency HIV Study (WIHS)
Institutions: University of California, San Francisco, University of California, Berkeley, San Francisco VA Medical Center, San Francisco VA Health Care System, Johns Hopkins University, Johns Hopkins Medicine, Yale University, Cincinnati Children's Hospital Medical Center, John H. Stroger, Jr. Hospital of Cook County, Cook County Health and Hospitals System, University of Southern California, State University of New York, SUNY Downstate Health Sciences University, Albert Einstein College of Medicine, Georgetown University, Georgetown University Medical Center
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Veterans Affairs, Northern California Institute for Research and Education, Georgia Clinical and Translational Science Alliance, National Institutes of Health, Center for AIDS Research, University of Washington, University of California, San Francisco, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, Office of Research on Women's Health, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1044130170, G1089263533, G1111999087, G1166984944, G12089860, G1255407591, G1344608833, G1446261281, G1621222477, G1835874845, G2277270920, G2387423928, Emory R38 Research Training Program, G2583540734, G2755707676, G2839755957, G3089064904, G3181090803, The Connie Wofsy Women's HIV Study, G3481933404, Brooklyn Women's Interagency HIV Study (WIHS) V, Miami Womens Interagency HIV Study WIHS, G3671922257, G4010343525, G4019075231, G4263984760, G4333671923, G4361283536, G4371267688, WIHS Data Management and Analysis Center (WDMAC), G4500389830, G4558954805, G483408255, Chicago WIHS Consortium V (CWC), G5411330681, G5411403494, Washington Women's Interagency HIV/AIDS Study, G5641536491, G5655542889, G5656926381, G592158972, G6212232794, G6300780520, G6341392406, G647763927, G6576622550, G661928818, G669420692, G6990385686, University of North Carolina Womens Interagency HIV Study UNC WIHS, G7479905529, G767062161, G773494495, G775892330, G7807729167, G81379742, G8448522485, G8846374971, UAB-MISS WIHS Cohort, G9000029981, G9000039899, G9000052758, G9000059706, G9000075308, G9000078127, G9000080293, G9000081039, G9000084207, G9000100957, G9000110076, G9000122276, G9000123130, G9000177630, G9000216739, Emory Specialized Center of Research Excellence (SCORE) on Sex Differences, Traineeships in AIDS Prevention Studies, Biomarker-Based Diagnostic Algorithms To Prevent, Detect And Guide Treatment Of Kidney Disease In Persons Living With HIV, Center for AIDS Prevention Studies (CAPS), Yale Clinical and Translational Science Award, G97119092, G986692823
OpenAlex ID: W2537503706