Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Academic Article


  • Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P <. 05). However, there were no differences in biomarkers by disease stage after 12 months of ART (n = 438; P >. 05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P <. 001). Earlier initiation of ART is associated with decreased inflammation, but levels seem to converge between earlier and later initiators surviving to 12 months.
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    Digital Object Identifier (doi)

    Author List

  • Siedner MJ; Bwana MB; Asiimwe S; Amanyire G; Musinguzi N; Castillo-Mancilla J; Tracy RP; Katz IT; Bangsberg DR; Hunt PW
  • Start Page

  • 1172
  • End Page

  • 1177
  • Volume

  • 220
  • Issue

  • 7