Evidence map›Paper›PMID 42113461›Full record

Observational studyInfection2026

Viral suppression is associated with rising NT-proCNP levels and reduced systemic inflammation in people living with HIV.

Istvan Bojti, Sarolta Bojtine Kovacs, Antonia Ziegler, Noah Jung, Alexander Maier, Dirk Westermann, Jean-Luca Funk, Philipp Mathé, Geertje Fink, Susanne Usadel and 4 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02149004 (Translational Research Platform of the TTU HIV of the German Center for Infection Research), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02149004 recruitingnot on this map

Translational Research Platform of the TTU HIV of the German Center for Infection Research (DZIF)

TypeobservationalSponsorUniversity Hospital of CologneRan2015 to 2035Enrolled10,000ConditionsHIV
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Istvan BojtiDepartment of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. istvan.bojti@uniklinik-freiburg.de.
Sarolta Bojtine KovacsIMM-PACT Cluster of Excellence, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Antonia ZieglerDepartment of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Noah JungDepartment of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Alexander MaierDepartment of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Dirk WestermannDepartment of Cardiology and Angiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Jean-Luca FunkDivision of Infectious Diseases, Department of Medicine II, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Philipp MathéDivision of Infectious Diseases, Department of Medicine II, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Geertje FinkDepartment of Infection Medicine, Medical Service Centre Clotten, Freiburg, Germany.
Susanne UsadelDepartment of Infection Medicine, Medical Service Centre Clotten, Freiburg, Germany.
Siegbert RiegDivision of Infectious Diseases, Department of Medicine II, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Gabor Tamas SzaboDivision of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Daniel CzurigaDivision of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Matthias C MüllerDivision of Infectious Diseases, Department of Medicine II, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople living with HIV (PLWH) have an increased risk of cardiovascular disease that persists despite effective antiretroviral therapy (ART) and viral suppression. Chronic inflammation and endothelial dysfunction are central contributors, yet integrative biomarkers linking viral activity, inflammation, and vascular homeostasis remain poorly defined. N-terminal pro-C-type natriuretic peptide (NT-proCNP), a marker of endothelial function and cardiovascular stress, is responsive to inflammatory states, and is processed by furin, a protease also required for viral entry. Data on NT-proCNP in PLWH are scarce. The aim of this study was to investigate longitudinal changes in NT-proCNP in relation to HIV viral load and systemic inflammation in PLWH starting ART.

methodsIn this exploratory longitudinal observational study, we included PLWH aged ≥ 18 years with initial diagnosis of HIV between 09/2023 and 06/2025. Before and approximately 3 months after initiation of ART plasma NT-proCNP, furin, and a multiplex panel of inflammatory cytokines were measured alongside HIV viral load, CD4⁺ T-cell count, serum creatinine, and C-reactive protein. Paired comparisons were performed using the Wilcoxon matched-pairs signed-rank test with false discovery rate (FDR) correction using the Benjamini-Krieger-Yekutieli method (Q = 5%). Correlations between longitudinal changes were explored using Spearman analysis with FDR adjustment.

resultsNT-proCNP concentrations increased significantly over time (33.7 [25.3-40.7] vs. 39.4 [31.2-55], p = 0.006), while a broad range of inflammatory cytokines showed significant reduction after FDR correction. Circulating furin concentrations did not change significantly. Correlation analyses between changes in NT-proCNP and individual inflammatory or virological markers were not significant after FDR correction.

conclusionIn this study we present first-time data on the impact of the initiation of ART on the levels and dynamics of NT-proCNP in PLWH. Suppression of HIV replication is accompanied by reduced systemic inflammation and a significant increase in circulating NT-proCNP, suggesting the restoration of vascular homeostatic signaling during early follow-up. NT-proCNP may represent an integrative biomarker linking viral control, inflammation, and cardiovascular biology in HIV infection, warranting further investigation in larger prospective studies with clinical cardiovascular endpoints. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION: NCT02149004, 23.05.2014.

Indexed as

HIV InfectionsInflammationNatriuretic Peptide, C-TypeViral LoadAdultBiomarkersFemaleHumansLongitudinal StudiesMaleMiddle Agedamino-terminal pro-C-type natriuretic peptide, humanBiomarkersNatriuretic Peptide, C-TypeARTHIVInflammationNT-proCNP

Identifiers

PMID42113461
PMCPMC13476305

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Registered trials

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.