ArticleOpen forum infectious diseases2017
Systemic Inflammation, Coagulation, and Clinical Risk in the START Trial.
Article in Open forum infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
49 citing papers in PubMed, 85 citations in OpenAlex.
- Statin effects on the incidence of major non-cardiovascular disease events among a global cohort of people with HIV: a randomised controlled trial.The lancet. HIV · 2025Trial
- ART in HIV-Positive Persons With Low Pretreatment Viremia: Results From the START Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Incomplete ART adherence is associated with higher inflammation in individuals who achieved virologic suppression in the START study.Journal of the International AIDS Society · 2019Trial
- Risk Factors for Low CD4+ Count Recovery Despite Viral Suppression Among Participants Initiating Antiretroviral Treatment With CD4+ Counts > 500 Cells/mm3: Findings From the Strategic Timing of AntiRetroviral Therapy (START) Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- A novel plasma proteomic signature predicts long-term incident heart failure risk among persons living with HIV.medRxiv : the preprint server for health sciences · 2026Article
- Predicting immune reconstitution after antiretroviral therapy in HIV/AIDS using ensemble machine learning: a real-world study.Frontiers in immunology · 2026Article
- Evaluation of cabotegravir plus rilpivirine in routine clinical settings in Japan: A multicentre study of efficacy, safety and biomarker dynamics.HIV medicine · 2025Observational
- Angiogenic CD8 T cells from PWH induce Granzymes-dependent PAR1 activation promoting endothelial inflammation.bioRxiv : the preprint server for biology · 2025Article
- Changes in cerebrospinal fluid proteins across the spectrum of untreated and treated chronic HIV-1 infection.PLoS pathogens · 2024Article
- Inflammatory and Immune Mechanisms for Atherosclerotic Cardiovascular Disease in HIV.International journal of molecular sciences · 2024Review
- Machine learning models based on fluid immunoproteins that predict non-AIDS adverse events in people with HIV.iScience · 2024Article
- Early trajectories of virological and immunological biomarkers and clinical outcomes in patients admitted to hospital for COVID-19: an international, prospective cohort study.The Lancet. Microbe · 2024Article
- Brief communications: changes in inflammatory biomarkers and lipid profiles after switching to long-acting cabotegravir plus rilpivirine.AIDS research and therapy · 2024Article
- Very-Low-Level Viremia, Inflammatory Biomarkers, and Associated Baseline Variables: Three-Year Results of the Randomized TANGO Study.Open forum infectious diseases · 2024Article
- Pneumoproteins and biomarkers of inflammation and coagulation do not predict rapid lung function decline in people living with HIV.Scientific reports · 2023Article
- Residual Central Nervous System Immune Activation Is Not Prevented by Antiretroviral Therapy Initiated During Early Chronic HIV Infection.Open forum infectious diseases · 2023Article
- Longitudinal patterns of inflammatory mediators after acute HIV infection correlate to intact and total reservoir.Frontiers in immunology · 2023Article
- Circulating biomarker correlates of left atrial size and myocardial extracellular volume fraction among persons living with and without HIV.BMC cardiovascular disorders · 2022Article
- Using plasma proteomics to investigate viral infections of the central nervous system including patients with HIV-associated neurocognitive disorders.Journal of neurovirology · 2022Article
- Immune correlates of cardiovascular co-morbidity in HIV infected participants from South India.BMC immunology · 2022Article
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 7 countries.
Funding
Abstract
backgroundThe Strategic Timing of AntiRetroviral Treatment (START) trial demonstrated that immediate (at CD4+ >500 cells/µL) vs deferred (to CD4+ <350 cells/µL or AIDS) antiretroviral therapy (ART) initiation reduced risk for AIDS and serious non-AIDS (SNA). We investigated associations of inflammation, coagulation, and vascular injury biomarkers with AIDS, SNA or death, and the effect of immediate ART initiation.
methodsBiomarkers were measured from stored plasma prior to randomization and at month 8. Associations of baseline biomarkers with event risk were estimated with Cox regression, pooled across groups, adjusted for age, gender, and treatment group, and stratified by region. Mean changes over 8 months were estimated and compared between the immediate and deferred ART arms using analysis of covariance models, adjusted for levels at entry.
resultsBaseline biomarker levels were available for 4299 START participants (92%). Mean follow-up was 3.2 years. Higher levels of IL-6 and D-dimer were the only biomarkers associated with risk for AIDS, SNA or death, as well as the individual components of SNA and AIDS events (HRs ranged 1.37-1.41 per 2-fold higher level), even after adjustment for baseline CD4+ count, HIV RNA level, and other biomarkers. At month 8, biomarker levels were lower in the immediate arm by 12%-21%.
conclusionsThese data, combined with evidence from prior biomarker studies, demonstrate that IL-6 and D-dimer consistently predict clinical risk across a broad spectrum of CD4 counts for those both ART-naïve and treated. Research is needed to identify disease-modifying treatments that target inflammation beyond the effects of ART.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.