Plasma biomarkers of HIV-related systemic inflammation and immune activation in sub-Saharan Africa before and during suppressive antiretroviral therapy.

We evaluated immune biomarker profiles in HIV-infected adults (n=398) from 5 African countries. Although all biomarkers decreased after ART initiation, CXCL10, LBP, CRP, sCD163 and sCD14 were significantly higher during ART than in an HIV-negative reference group (n=90), indicating persistent monocyte/macrophage activation, inflammation and microbial translocation. Before ART initiation, high HIV viral load was associated with elevated CXCL10 and tuberculosis coinfection was associated with elevated sCD14. High pre-ART levels of each biomarker strongly predicted residual immune activation during ART. CCL2, LBP, CRP, IL-6 were differentially expressed between countries. Further research is needed on the clinical implications of residual immune dysregulation.