Early Evolution of Plasma Soluble TNF- α p75 Receptor as a Marker of Progression in Treated HIV-Infected Patients

Abstract

We evaluated the prognostic value of different mediators of inflammation: TNF-α and its soluble receptor p75, platelet-activating factor, and glutathione tripeptide in a case–control study nested within a cohort of 1281 patients infected by the human immunodeficiency virus (HIV) started on highly active antiretroviral treatment (HAART). During the first year of HAART, 16 cases experienced an AIDS-defining event and 6 experienced an evolution of T CD4⁺ cell count <100/mm³. Forty-four controls who did not progress during the same follow-up period were matched for age, baseline CD4⁺, and HIV-RNA. In the control group, plasma levels of TNF-α and its soluble receptor p75 decreased significantly from baseline to month 4: from 11.0 to 8.7 pg/ml (p < 0.001) and from 27.3 to 22.8 pg/ml (p < 0.003), respectively. Furthermore the decrease of TNF-α soluble receptor p75 was larger in nonprogressors than in progressors (p = 0.003). Measurement of TNF-α soluble receptor p75 may be of interest as an additional marker of early antiretroviral effect.