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Serious Non-AIDS Events and Biomarker Changes in HIV-1-Infected Individuals -
Inflammation Markers & Comorbidities: higher markers in HIV+ with comorbidities
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Reported by Jules Levin
IAS 2015 Vancouver July 19-23
Meena Sunil1, Netanya S. Utay2, Roberto C. Arduino1, Maria Laura Martinez1,
Xiaoying Yu3, Anoma Somasundaram2, Maitreyee Nigalye2, Tanvir Bell1
1-University of Texas Health Science Center-Houston
2- University of Texas Medical Branch- Galveston
3- Baylor College of Medicine
"The absolute levels of inflammatory biomarkers and their rate of change over time may be relevant for predicting SNAEs (comorbidities)......Most prevalent SNAE was CVD......illegal substance use was significantly associated with events ......People with current illegal substance use were more likely to have events than never users ....from Jules: biomarkers were higher in patients experiencing comorbidities (see Table 4)....the authors conclude: "both the absolute levels of inflammatory biomarkers and their rate of change over time may be relevant for predicting SNAEs"....perhaps I could say if you keep your inflammation markers low, very low, you may be at greatly reduced risk for developing a comorbidity, and what is the best way to keep inflammation markers very low? keep viral load undetectable, maximize CD4 count, and exercise & diet; so what does exercise & diet mean? well, studies report vigorous exercise is perhaps the best way to reduce inflammation, reduce inflammation markers, immune activation & prevent comorbidities, improve brain function, reduce risk for heart disease, keep sugar under control & thus reduce risk for kidney disease & as well walking/running improves bone strength, and although vigorous exercise may reduce risk & improve health more walking for 30 minutes a day helps and is a start. What is vigorous exercise? jogging, resistance (weights), biking, swimming for 30-60 minutes a day 4-6 days a week. What is good diet? reduce saturated fats, avoid unhealthy fats, increase good fats like avocados, extra virgin olive oil, don't overload carbs, vegetables & fruits are very healthy; try to eat organic. studies find soy improves health & reduces risks for comorbidities & red meat increases risk, watch the types of proteins you eat; properly/healthier raised chickens are healthier than cheap brand chickens. Studies show Fish is good for you.
from Jules: HIV+ with current substance abuse or alcohol use use were more likely to have a comorbidity; HIV+ who never used alcohol or illicit substance abuse were less likely to have a comorbidity. this is an important point, many studies are conducted in identifying factors related to comorbidities such as is onset accelerated, who gets them more often, but I never see the study analysis stratified by current or past alcohol/substance abuse or not. As well, you rarely if ever see these studies stratified by who or does not have abnormal immune markers, another important point in understanding aging & who gets comorbidities & who experiences accelerated onset. OF NOTE 70% of patients in this study had HCV - HCV can increase inflammation as well, a little known fact - On another note - SERVICES NEEDED FOR AGING - with soon over 30% with HIV will be over 60 yrs old & 50% over 50 there will be increases in patients becoming frailtyl & with gait problems, increased reduced mobility, depression, housing problems, worsening income loss, yes increased suicides & of course specialized & increased clinical care needs - providers who can identify, privet, care for & treat comorbidities effectively, and overall providers are not well prepared to effectively take care of these needs. The Federal & NYS governments ARE NOT DISCUSSING these problems - never mind forging solutions - mostly neither are advocates - WEIGH IN let your voice be heard!
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