1323. SCD14 and SCD163 Levels are correlated with Veterans Aging Cohort Study (VACS) Index Scores: Initial Data from the Blunted Immune Recovery in CORE patients with HIV (BIRCH) cohort
Session: Poster Abstract Session: Biomarkers and Correlates of Protection
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA poster BW #1323.pdf (204.2 kB)
  • Background: HIV+ patients (pts) with blunted CD4 recovery on highly active antiretroviral therapy (HAART) are at higher risk for AIDS and non-AIDS morbidity and mortality than are those with CD4 counts > 500/mm3. The VACS  index which includes 7 variables ; Age, CD4 count, HIVRNA, hemoglobin, FIB-4, eGFR and Hepatitis C status has recently been validated  as a reliable index to assess 5- year mortality risk in HIV patients.  Elevated levels of sCD14, sCD163 (markers of monocyte/macrophage activation) correlate with morbidity/mortality in HIV pts. We assessed the relationship between sCD14, sCD163 and VACS scores in pts with a blunted CD4 recovery on HAART.

    Methods: HIV+ pts with >12months of continuous virologic suppression and persistent CD4 <250 cells/mm3 were enrolled at the CORE Center, Chicago. Elisa assays for sCD14 and sC163 were performed at Blood Systems, CA. Descriptive statistics were performed using SAS.

    Results: As of March 2013, 40 pts with a median age of 55 yrs IQR (49-61) have been enrolled. 88% were male, 58% African American, 21% Caucasian and 16% Hispanic. 30% were HCV+.  Median nadir and current CD4 counts were 42 and 164cells/mm³ respectively. Median duration of HIV suppression was 32 months IQR (21-55).  21% were obese and 47% were current smokers.  Vitamin D deficiency (<20ng/mL) was present in 50% and hsCRP was elevated >3mg/L in 28%. 10 year Framingham cardiac risk (FCR) was >10% in 23% of pts. The mean (SD) VACS score was 38 (22); 29% had VACS scores>50 and 7% >70 which indicate a 25% and 50% 5-yr mortality risk respectively. Median sCD14 was 1895 ng/mL and sCD163, 1084ng/mL.  There were significant correlations between sCD14 and VACS scores (r=0.46, p=0.004) and between sCD163 and VACS scores (r=0.44, p=0.005). No correlation was found between scD14, sCD163 and FCR.

    Conclusion: In the BIRCH cohort, there was a high prevalence of modifiable risk factors for co-morbid illness such as obesity, smoking, vitamin D deficiency and elevated hsCRP. 20% had >10% (moderate risk) FCR scores and 29% had high risk VACS scores.  Levels of sCd14 and sCD163 correlated highly with VACS scores. Many pts with blunted CD4 recovery after viral suppression remain at high risk and aggressive identification and management of modifiable risk factors should be part of clinical care.

    Brett Williams, MD, Infectious Disease, Rush University, Chicago, IL; Infectious Disease, CORE Center, Chicago, IL; Infectious Disease, John Stroger Hospital of Cook County, Chicago, IL, Britt Livak, MPH, Chicago Developmental Center for AIDS Research (DCFAR), Chicago, IL, Mieoak Bahk, CORE Center, Chicago, IL and Oluwatoyin Adeyemi, MD, Ruth M Rothstein CORE Center, Cook County Hospital and Rush University Medical Center, Chicago, IL

    Disclosures:

    B. Williams, None

    B. Livak, None

    M. Bahk, None

    O. Adeyemi, None

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