Timing of Antiretroviral Therapy and Systemic Inflammation in Sub-Saharan Africa: Results from the META Longitudinal Cohort Study

Abstract

Chronic inflammation predicts complications in persons with human immunodeficiency virus infection. We compared D-dimer, soluble CD14, and interleukin 6 levels before and 12 months after antiretroviral therapy (ART) initiation, among individuals starting ART during earlier-stage (CD4 T-cell count >350/μL) or late-stage disease (CD4 T-cell count <200/μL). Female sex, older age, viral load, and late-stage disease were associated with pre-ART biomarkers (n = 661; P. 05), owing to loss from observation and greater declines in biomarkers in late-stage initiators (P