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Immunoregulatory Pathways Predict Mortality More Strongly in People With Versus Without HIV
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CROI 2024 March 3-6 Denver
The current paradigm is that inflammation (the accelerator in this car analogy) is increased and predicts mortality in people with HIV. We identified numerous pro-inflammatory proteins associated with mortality not only in HIV, but also in the general population. However, when directly comparing these populations, we observed that immunoregulatory proteins (the brake pedal) rather than pro-inflammatory ones were preferentially associated with mortality risk in the context of HIV.
The excess mortality risk in HIV may not be simply about stomping on the accelerator, but rather by also slamming on the brakes. We have previously published that even in those who start ART very early and remain suppressed, immunoregulatory rather than inflammatory pathways remain persistently elevated compared to HIV-negative controls. These findings taken together may be especially relevant for cancer or infections, for which people with HIV are known to be at an even greater risk for compared to other diseases.
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