Kirkegaard-Klitbo D, Mejer N, Knudsen T, Møller H, Moestrup S, Nielsen S, Kronborg G, Benfield T

OBJECTIVE To examine if monocyte and macrophage activity may be on the mechanistic pathway to non-AIDS comorbidity by investigating the associations between plasma soluble CD163 (sCD163) and incident non-AIDS comorbidities in well-treated HIV-infected individuals.

DESIGN Prospective single-center cohort study.

METHODS Plasma sCD163 was quantified by ELISA technique at study entry in 2004/05 and non-AIDS comorbidity was identified by International Classification of Disease Tenth revision (ICD-10) diagnosis codes and registry linkage in 2014/2015. Associations between sCD163 and incident comorbidity was examined using multivariable Cox proportional hazards models adjusted for pertinent covariates.

RESULTS In HIV-1 infected individuals (n=799), the highest quartile of plasma sCD163 was associated with incident chronic lung disease (adjusted hazard ratio (aHR), 3.2; 95% confidence interval (CI): 1.34; 7.46) and incident chronic kidney disease (aHR, 10.94; 95% CI: 2.32;51.35), when compared with lowest quartiles. Further, (every one mg) increase in plasma sCD163 was positively correlated with incident liver disease (aHR, 1.12; 95%CI: 1.05;1.19). The sCD163 level was not associated with incident cancer, CVD, or diabetes mellitus.

CONCLUSIONS sCD163 was independently associated with incident chronic kidney disease, chronic lung disease, and liver disease in treated HIV-1 infected individuals, suggesting that monocyte/macrophage activation may be involved in the pathogenesis of non-AIDS comorbidity and a potential target for therapeutic intervention.

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