Evidence mapPaperPMID 28991883Full record

Trial reportJournal of acquired immune deficiency syndromes (1999)2018

Inflammation-Related Morbidity and Mortality Among HIV-Positive Adults: How Extensive Is It?

Brian B Hart, Anna D Nordell, Jason F Okulicz, Adrian Palfreeman, Andrzej Horban, Eynat Kedem, Jacqueline Neuhaus, David R Jacobs, Daniel A Duprez, James D Neaton and 1 more

Abstract readClinical Trial
In one paragraph

Trial report in Journal of acquired immune deficiency syndromes (1999), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.

0numbers the graph read from it
0cells of the map it votes in
41citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed.

  1. Trial
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  10. Review
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  14. Review
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  16. HIV, HIV-Specific Factors, and Myocardial Disease in Women.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
  17. Article
  18. Article
  19. Review
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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

11 authors.

Brian B HartDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.
Anna D NordellNorth American Science Associates, Minneapolis, MN.
Jason F OkuliczInfectious Disease Service, San Antonio Military Medical Center, Fort Sam Houston, TX.
Adrian PalfreemanDepartment of Infectious Diseases, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
Andrzej HorbanDepartment of Adult Infectious Diseases, Medical University of Warsaw, Warsaw, Poland.
Eynat KedemDepartment of Immunology, Allergy and AIDS, Rambam Health Care Center, Haifa, Israel.
Jacqueline NeuhausDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.
David R JacobsDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
Daniel A DuprezCardiovascular Division, University of Minnesota, Minneapolis, MN.
James D NeatonDivision of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.
INSIGHT SMART and ESPRIT Groups

Funding

COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ON AIDSU01AI046362 · SOCIAL AND SCIENTIFIC SYSTEMS, INC. · 2000 to 2005
$68.0M
INTERNATIONAL PHASE III IL-2 STUDYU01AI046957 · UNIVERSITY OF MINNESOTA TWIN CITIES · 1999 to 2005
$56.4M
TERRY BEIRN COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ONU01AI042170 · UNIVERSITY OF MINNESOTA TWIN CITIES · 1997 to 2005
$21.4M
Medical Research Council MC_UU_12023/23NIAID NIH HHS U01 AI042170NIAID NIH HHS U01 AI046362NIAID NIH HHS U01 AI046957NIAID NIH HHS U01 AI068641
6 · The paper itself

Abstract

objectiveTo determine the rate of grade 4, potentially life-threatening events not attributable to AIDS, cardiovascular disease (CVD), or non-AIDS cancer among participants on antiretroviral therapy and to describe associations of these events with interleukin-6 (IL-6) and D-dimer.

designCohort study.

methodsHIV-infected participants on antiretroviral therapy (N = 3568) with an HIV-RNA level ≤ 500 copies/mL were followed for grade 4, AIDS, CVD, non-AIDS cancer, and all-cause mortality events. Grade 4 events were further classified masked to biomarker levels as reflecting chronic inflammation-related disease (ChrIRD) or not (non-ChrIRD). Associations of baseline IL-6 and D-dimer with events were studied using Cox models.

resultsOver a median follow-up of 4.3 years, 339 participants developed a grade 4 event (22.9 per 1000 person-years); 165 participants developed a ChrIRD grade 4 event (10.7 per 1000 person-years). Grade 4 events were more common than AIDS (54 participants), CVD (132), and non-AIDS cancer (80) events, any of which developed in 252 participants (17.1 per 1000 person-years). Grade 4 and AIDS events were associated with similar risks of death. Higher IL-6 [hazard ratio (HR) = 1.19 per doubling of biomarker; P = 0.003] and D-dimer (HR = 1.23; P < 0.001) levels were associated with an increased risk of grade 4 events. IL-6 associations were stronger for ChrIRD (HR = 1.38; P < 0.001) than non-ChrIRD grade 4 events (HR = 1.11; P = 0.21).

conclusionsMorbidity and mortality associated with activation of inflammatory and coagulation pathways include conditions other than AIDS, CVD, and non-AIDS cancer events. Effective inflammation-dampening interventions could greatly affect the health of people with HIV.

Indexed as

InflammationAdultAgedAntiretroviral Therapy, Highly ActiveBiomarkersBlood CoagulationCohort StudiesFemaleFibrin Fibrinogen Degradation ProductsHIVHIV InfectionsHIV SeropositivityHumansInterleukin-6MaleMiddle AgedBiomarkersFibrin Fibrinogen Degradation Productsfibrin fragment DIL6 protein, humanInterleukin-6

Identifiers

PMID28991883
PMCPMC5720921

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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 Socratic graph.