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Mediators of Inflammation
Volume 2014, Article ID 198413, 7 pages
http://dx.doi.org/10.1155/2014/198413
Clinical Study

Circulating Biomarkers of Immune Activation Distinguish Viral Suppression from Nonsuppression in HAART-Treated Patients with Advanced HIV-1 Subtype C Infection

1Medical Research Council Unit for Inflammation and Immunity, Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
2Africa Centre for Health and Population Studies, Mtubatuba 3935, South Africa
3Jembi Health Systems NPC, Cape Town, Cape Town 7945, South Africa
4School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Westville 3600, South Africa
5Department of Cancer Immunology and AIDS, Dana Farber Cancer Institute, Boston MA02215, MA, USA

Received 20 November 2013; Accepted 25 February 2014; Published 6 April 2014

Academic Editor: Jyoti J. Watters

Copyright © 2014 Glen Malherbe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Few studies have examined immune activation profiles in patients with advanced HIV-1 subtype C infection or assessed their potential to predict responsiveness to HAART. BioPlex, ELISA, and nephelometric procedures were used to measure plasma levels of inflammatory biomarkers in HIV-1 subtype C-infected patients sampled before and after 6 months of successful HAART ; in patients failing HAART ; and in uninfected controls . Prior to HAART, CXCL9, CXCL10, β2M, sTNF-R1, TGF-β1, IFN-γ, IL-6, TNF, and sCD14 were significantly elevated in HIV-1-infected patients compared to controls . All of these markers, with the exception of sTNF-R1, were also elevated in patients failing HAART . The persistently elevated levels of CXCL9, CXCL10, and β2M in patients failing therapy in the setting of a marked reduction in these markers in patients on successful HAART suggest that they may be useful not only to monitor immune activation during HAART, but also to distinguish between good and poor responders. In the case of sCD14 and TGF-β1, the levels of these biomarkers remained persistently elevated despite HAART-induced virological suppression, a finding that is consistent with ongoing monocyte-macrophage activation, underscoring a potential role for adjuvant anti-inflammatory therapy.