Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2015
Concurrent Anemia and Elevated C-Reactive Protein Predicts HIV Clinical Treatment Failure, Including Tuberculosis, After Antiretroviral Therapy Initiation.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Pooled it
- Vitamin A and D Deficiencies Associated With Incident Tuberculosis in HIV-Infected Patients Initiating Antiretroviral Therapy in Multinational Case-Cohort Study.Journal of acquired immune deficiency syndromes (1999) · 2017Trial
- Gut feelings and sweet teeth: nutritional solutions to the gut damage in inflammatory bowel disease and HIV infection.Frontiers in nutrition · 2026Review
- Inflammation, antiretroviral therapy continuation, and HIV disease progression in postpartum women with HIV.Journal of acquired immune deficiency syndromes (1999) · 2025Article
- Review
- Impact of Isoniazid Preventive Therapy on Tuberculosis Incidence and Predictors of Tuberculosis Among People Living With HIV/AIDS at Debre Tabor General Hospital, Northwest Ethiopia.Tuberculosis research and treatment · 2024Article
- The burden of anemia among Chinese HIV-infected patients following the initiation of antiretroviral therapy in the treat-all era: a nationwide cohort study.BMC infectious diseases · 2023Article
- Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER trial.EClinicalMedicine · 2023Article
- Plasma hemoglobin and the risk of death in HIV/AIDS patients treated with antiretroviral therapy.Aging · 2021Article
- Systemic Inflammation Associated with Immune Reconstitution Inflammatory Syndrome in Persons Living with HIV.Life (Basel, Switzerland) · 2021Review
- Impact of Persistent Anemia on Systemic Inflammation and Tuberculosis Outcomes in Persons Living With HIV.Frontiers in immunology · 2020Article
- Development and validation of a prognostic nomogram for HIV/AIDS patients who underwent antiretroviral therapy: Data from a China population-based cohort.EBioMedicine · 2019Article
- The impact of antiretroviral therapy on iron homeostasis and inflammation markers in HIV-infected patients with mild anemia.Journal of translational medicine · 2017Article
- Sex-Related Differences in Inflammatory and Immune Activation Markers Before and After Combined Antiretroviral Therapy Initiation.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Variation in C - reactive protein response according to host and mycobacterial characteristics in active tuberculosis.BMC infectious diseases · 2016Article
- Health-related quality of life is inversely correlated with C-reactive protein and age in Mycobacterium avium complex lung disease: a cross-sectional analysis of 235 patients.Respiratory research · 2015Article
Corrections and comments
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Authors and funding
23 authors at 16 institutions in 8 countries.
Funding
Abstract
backgroundAnemia is a known risk factor for clinical failure following antiretroviral therapy (ART). Notably, anemia and inflammation are interrelated, and recent studies have associated elevated C-reactive protein (CRP), an inflammation marker, with adverse human immunodeficiency virus (HIV) treatment outcomes, yet their joint effect is not known. The objective of this study was to assess prevalence and risk factors of anemia in HIV infection and to determine whether anemia and elevated CRP jointly predict clinical failure post-ART.
methodsA case-cohort study (N = 470 [236 cases, 234 controls]) was nested within a multinational randomized trial of ART efficacy (Prospective Evaluation of Antiretrovirals in Resource Limited Settings [PEARLS]). Cases were incident World Health Organization stage 3, 4, or death by 96 weeks of ART treatment (clinical failure). Multivariable logistic regression was used to determine risk factors for pre-ART (baseline) anemia (females: hemoglobin <12.0 g/dL; males: hemoglobin <13.0 g/dL). Association of anemia as well as concurrent baseline anemia and inflammation (CRP ≥ 10 mg/L) with clinical failure were assessed using multivariable Cox models.
resultsBaseline anemia prevalence was 51% with 15% prevalence of concurrent anemia and inflammation. In analysis of clinical failure, multivariate-adjusted hazard ratios were 6.41 (95% confidence interval [CI], 2.82-14.57) for concurrent anemia and inflammation, 0.77 (95% CI, .37-1.58) for anemia without inflammation, and 0.45 (95% CI, .11-1.80) for inflammation without anemia compared to those without anemia and inflammation.
conclusionsART-naive, HIV-infected individuals with concurrent anemia and inflammation are at particularly high risk of failing treatment, and understanding the pathogenesis could lead to new interventions. Reducing inflammation and anemia will likely improve HIV disease outcomes. Alternatively, concurrent anemia and inflammation could represent individuals with occult opportunistic infections in need of additional screening.
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