AIDS: C-reactive protein predicts the rate of progression to disease stage

The plasma concentration of C-reactive protein (CRP) can predict the rate of progression of HIV-positive patient (HIV +) to the AIDS-stage disease, according to a study published in the Archives of Internal Medicine.

Several studies have shown that CRP, a marker of inflammation, possible to assess the risk of stroke. The Centers for Disease Control and Prevention (CDC) have recommended the use of this protein as a marker of risk in this indication. But also its concentration increases during infection.

Dr. Bryan Lau, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues sought to determine the dynamics of CRP in 513 HIV + patients to find out if she could be a marker of progression to AIDS stage Medicare. A retrospective study was conducted on plasma samples collected between 1983 and 1994.

Among the 318 patients (62%) who have reached the stage of AIDS before 1994, the plasma CRP concentration was 1.3 mg per liter, versus 1 mg per liter in others.

Time of progression to AIDS-stage disease decreased when the concentration of CRP increased. It was thus 7.7 years, 6.87 years, 5.07 years and 4.48 years for those with less than 0.6 mg per liter and concentrations between 0.7 and 1 mg per liter, 2 mg per liter, between 1.3 mg and 2.3 mg per liter per liter in excess of 2.3 mg per liter.

Furthermore, an analysis carried out on 81 of these patients showed that, beyond having a higher CRP concentration of this protein increased more rapidly in patients who reached the stage AIDS health thereafter. Each year, it was growing at home by 8.5% against 4.5% in patients without AIDS stage.

The researchers did, however, found no effect of antiretroviral drugs on the level of CRP. The study was conducted on blood samples of the first antiretroviral contemporary market, but before the appearance of highly active antiretroviral therapy (HAART) in 1996, they recognized.

"These findings suggest a potential role of CRP in monitoring the clinical course of people infected with HIV," the researchers estimated.

However, they acknowledged that measures CRP "can clearly not replace CD4 and viral load during follow-up," saying that such a tool, for reasons of cost, would be out of reach in emerging markets.

Recalling the work of objectifying a link between CRP and the risk of stroke, researchers reported ignore if this prognostic value was maintained in the presence of HIV. According to them, the only study on the subject, although they included a small number of people found that CRP levels did not influence significantly on the risk for HIV.