Changes in Urinary Biomarkers over 10 Years is Associated with Viral Suppression in a Prospective Cohort of Women Living with HIV

for the Women’s Interagency HIV Study (WIHS)

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND:: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in three urine biomarkers over 10 years among women living with HIV. METHODS:: Prospective cohort of 294 HIV-infected women from the multicenter Women’s Interagency HIV Study (WIHS). Predictors included HIV viral and immunological parameters, co-morbid conditions and health-related behaviors. Outcomes were patterns of changes of urine interleukin-18 (IL-18), albumin-to-creatinine ratio (ACR) and alpha-1-microglobulin (α1m) over 10 years. We used quantile regression to examine patterns of change in each urine biomarker during follow-up and multivariable analysis of variance (MANOVA) regression to identify predictors of biomarker changes. RESULTS:: Over 10 years, the median concentrations of IL-18 declined from 120 to 64 pg/mL, α1m rose from 0.7 to 1.5 ng/mL, and ACR remained stable (9 to 8 mg/g). In multivariate analyses, the strongest predictors of increases in IL-18 were higher baseline BMI, increase in waist circumference, higher follow-up HIV viral load, lower follow-up CD4 cell count, HCV co-infection and higher follow-up HDL cholesterol. Predictors of increasing concentration of α1m were lower CD4 cell counts, higher diastolic blood pressure, HCV co-infection and smoking. Finally, determinants of ACR increases during follow-up were higher follow-up diastolic blood pressure, HCV co-infection, higher follow-up HIV viral load and triglyceride concentration. CONCLUSIONS:: Over 10 years, HIV disease status had different associations with each urine biomarker under study. Overall, the associations with changes in each biomarker support research into their use for longitudinal monitoring of kidney health.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
DOIs
StateAccepted/In press - Oct 18 2016

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Biomarkers
HIV
Interleukin-18
Urine
Coinfection
Albumins
Creatinine
CD4 Lymphocyte Count
Blood Pressure
Viral Load
Health
Kidney Diseases
Waist Circumference
HDL Cholesterol
HIV Infections
Analysis of Variance
Triglycerides
Multivariate Analysis
Smoking
Hypertension

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Changes in Urinary Biomarkers over 10 Years is Associated with Viral Suppression in a Prospective Cohort of Women Living with HIV. / for the Women’s Interagency HIV Study (WIHS).

In: Journal of Acquired Immune Deficiency Syndromes, 18.10.2016.

Research output: Contribution to journalArticle

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title = "Changes in Urinary Biomarkers over 10 Years is Associated with Viral Suppression in a Prospective Cohort of Women Living with HIV",
abstract = "BACKGROUND:: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in three urine biomarkers over 10 years among women living with HIV. METHODS:: Prospective cohort of 294 HIV-infected women from the multicenter Women’s Interagency HIV Study (WIHS). Predictors included HIV viral and immunological parameters, co-morbid conditions and health-related behaviors. Outcomes were patterns of changes of urine interleukin-18 (IL-18), albumin-to-creatinine ratio (ACR) and alpha-1-microglobulin (α1m) over 10 years. We used quantile regression to examine patterns of change in each urine biomarker during follow-up and multivariable analysis of variance (MANOVA) regression to identify predictors of biomarker changes. RESULTS:: Over 10 years, the median concentrations of IL-18 declined from 120 to 64 pg/mL, α1m rose from 0.7 to 1.5 ng/mL, and ACR remained stable (9 to 8 mg/g). In multivariate analyses, the strongest predictors of increases in IL-18 were higher baseline BMI, increase in waist circumference, higher follow-up HIV viral load, lower follow-up CD4 cell count, HCV co-infection and higher follow-up HDL cholesterol. Predictors of increasing concentration of α1m were lower CD4 cell counts, higher diastolic blood pressure, HCV co-infection and smoking. Finally, determinants of ACR increases during follow-up were higher follow-up diastolic blood pressure, HCV co-infection, higher follow-up HIV viral load and triglyceride concentration. CONCLUSIONS:: Over 10 years, HIV disease status had different associations with each urine biomarker under study. Overall, the associations with changes in each biomarker support research into their use for longitudinal monitoring of kidney health.",
author = "{for the Women’s Interagency HIV Study (WIHS)} and BAXI, {Sanjiv M.} and Rebecca SCHERZER and Vasantha JOTWANI and ESTRELLA, {Michelle M.} and ABRAHAM, {Alison G.} and PARIKH, {Chirag R.} and BENNETT, {Michael R.} and COHEN, {Mardge H.} and NOWICKI, {Marek J.} and GUSTAFSON, {Deborah R.} and Anjali Sharma and YOUNG, {Mary A.} and SHLIPAK, {Michael G.}",
year = "2016",
month = "10",
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AU - for the Women’s Interagency HIV Study (WIHS)

AU - BAXI, Sanjiv M.

AU - SCHERZER, Rebecca

AU - JOTWANI, Vasantha

AU - ESTRELLA, Michelle M.

AU - ABRAHAM, Alison G.

AU - PARIKH, Chirag R.

AU - BENNETT, Michael R.

AU - COHEN, Mardge H.

AU - NOWICKI, Marek J.

AU - GUSTAFSON, Deborah R.

AU - Sharma, Anjali

AU - YOUNG, Mary A.

AU - SHLIPAK, Michael G.

PY - 2016/10/18

Y1 - 2016/10/18

N2 - BACKGROUND:: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in three urine biomarkers over 10 years among women living with HIV. METHODS:: Prospective cohort of 294 HIV-infected women from the multicenter Women’s Interagency HIV Study (WIHS). Predictors included HIV viral and immunological parameters, co-morbid conditions and health-related behaviors. Outcomes were patterns of changes of urine interleukin-18 (IL-18), albumin-to-creatinine ratio (ACR) and alpha-1-microglobulin (α1m) over 10 years. We used quantile regression to examine patterns of change in each urine biomarker during follow-up and multivariable analysis of variance (MANOVA) regression to identify predictors of biomarker changes. RESULTS:: Over 10 years, the median concentrations of IL-18 declined from 120 to 64 pg/mL, α1m rose from 0.7 to 1.5 ng/mL, and ACR remained stable (9 to 8 mg/g). In multivariate analyses, the strongest predictors of increases in IL-18 were higher baseline BMI, increase in waist circumference, higher follow-up HIV viral load, lower follow-up CD4 cell count, HCV co-infection and higher follow-up HDL cholesterol. Predictors of increasing concentration of α1m were lower CD4 cell counts, higher diastolic blood pressure, HCV co-infection and smoking. Finally, determinants of ACR increases during follow-up were higher follow-up diastolic blood pressure, HCV co-infection, higher follow-up HIV viral load and triglyceride concentration. CONCLUSIONS:: Over 10 years, HIV disease status had different associations with each urine biomarker under study. Overall, the associations with changes in each biomarker support research into their use for longitudinal monitoring of kidney health.

AB - BACKGROUND:: Urine biomarkers have helped identify persons at risk for progressing to kidney disease in the setting of HIV infection. We explored factors associated with changes in three urine biomarkers over 10 years among women living with HIV. METHODS:: Prospective cohort of 294 HIV-infected women from the multicenter Women’s Interagency HIV Study (WIHS). Predictors included HIV viral and immunological parameters, co-morbid conditions and health-related behaviors. Outcomes were patterns of changes of urine interleukin-18 (IL-18), albumin-to-creatinine ratio (ACR) and alpha-1-microglobulin (α1m) over 10 years. We used quantile regression to examine patterns of change in each urine biomarker during follow-up and multivariable analysis of variance (MANOVA) regression to identify predictors of biomarker changes. RESULTS:: Over 10 years, the median concentrations of IL-18 declined from 120 to 64 pg/mL, α1m rose from 0.7 to 1.5 ng/mL, and ACR remained stable (9 to 8 mg/g). In multivariate analyses, the strongest predictors of increases in IL-18 were higher baseline BMI, increase in waist circumference, higher follow-up HIV viral load, lower follow-up CD4 cell count, HCV co-infection and higher follow-up HDL cholesterol. Predictors of increasing concentration of α1m were lower CD4 cell counts, higher diastolic blood pressure, HCV co-infection and smoking. Finally, determinants of ACR increases during follow-up were higher follow-up diastolic blood pressure, HCV co-infection, higher follow-up HIV viral load and triglyceride concentration. CONCLUSIONS:: Over 10 years, HIV disease status had different associations with each urine biomarker under study. Overall, the associations with changes in each biomarker support research into their use for longitudinal monitoring of kidney health.

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