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Antiretroviral Therapy and Inflammatory and Coagulation Biomarkers: iMACS Study

Completed
Conditions
HIV (Human Immunodeficiency Virus)
AIDS (Acquired Immune Deficiency Syndrome)
Tuberculosis
Non-communicable Diseases (NCD)
Registration Number
NCT02027480
Lead Sponsor
Columbia University
Brief Summary

The aim of this study is to develop and follow a cohort of human immunodeficiency virus (HIV)-infected adults who are starting HIV drugs at health facilities in Kenya. Blood and urine samples will be collected from all participants in order to establish a sample bank of samples in order to further the understanding of the levels of inflammatory biomarkers and coagulation biomarkers in African patients and the effect of taking HIV drugs on these biomarkers. This study will enroll and follow 685 men and women who are starting HIV drugs and collect blood and urine specimens from them at 4 study visits. These samples will be frozen and stored for future testing related to inflammatory and coagulation biomarkers.

Detailed Description

Biomarkers have been investigated as predictors of HIV disease progression, i.e. development of acquired immunodeficiency syndrome (AIDS) defining diagnoses or death. There are limited data on the levels of these biomarkers among HIV-infected individuals in sub Saharan Africa and on the effect of antiretroviral therapy (ART) initiation on these levels. In addition, further work is needed to examine the association between such markers and various complications associated with HIV as well as mortality in sub Saharan Africa. The overall aim of this study is to develop a cohort of HIV-infected adults who are initiating ART at health facilities in Kenya and to establish a sample bank of plasma and urine samples in order to further the understanding of the levels of inflammatory biomarkers (IBM) and coagulation biomarkers (CBM) in African patients and the effect of ART initiation on these biomarkers. The study objectives are as follows:

* To recruit, establish and follow a cohort of HIV-infected individuals who are eligible for initiation of ART through 12 months

* To obtain blood and urine samples on all cohort participants at baseline, months 2, 6, and 12 for future HIV and related research

* To describe the demographic and disease characteristics of cohort participants and associations with various biomarkers

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
685
Inclusion Criteria
  • Men and women at least 18 years of age
  • Known to be HIV positive
  • ART-naïve (with exception of prior exposure to single dose nevirapine in women)
  • Documented ART eligibility based on CD4+ cell count and/or WHO staging
  • Willing to provide locator information and to adhere to study procedures.
  • No intention of permanently moving away from area for coming 12 months
Read More
Exclusion Criteria
  • Individuals who do not meet the inclusion criteria outlined above
  • Women who are currently pregnant
  • Any condition which in the opinion of the investigators would interfere with participation in the study
Read More

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Change in mean high-sensitivity C-reactive protein (hsCRP) levels measured in mg/LBaseline to 12 months

Blood and urine samples of participants will be analyzed for inflammatory and coagulation biomarkers at four different times during this study to assess the change in marker levels.

Change in mean interleukin-6 (IL-6) levels measured in ng/mLBaseline to 12 months

Blood and urine samples of participants will be analyzed for inflammatory and coagulation biomarkers at four different times during this study to assess the change in marker levels.

Secondary Outcome Measures
NameTimeMethod
Prevalence (% of participants) of smoking in the study population12 months

Using baseline surveys, human specimens, and other physiological measures (i.e. BP screenings), the prevalence of risk factors for non-communicable diseases will be assessed.

Prevalence (% of participants) of high BMI in the study population12 months

Using baseline surveys, human specimens, and other physiological measures (i.e. BP screenings), the prevalence of risk factors for non-communicable diseases will be assessed.

Prevalence (% of participants) of cotinine in blood in the study population.12 months

Using baseline surveys, human specimens, and other physiological measures (i.e. BP screenings), the prevalence of risk factors for non-communicable diseases will be assessed.

Prevalence (% of participants) of diabetes in the study population.12 months

Using biomarkers, self-report, and other physiological tests (i.e. BP screenings), researchers will assess the prevalence of co-morbid conditions.

Prevalence (% of participants) of hypertension in the study population.12 months

Using biomarkers, self-report, and other physiological tests (i.e. BP screenings), researchers will assess the prevalence of co-morbid conditions.

Prevalence (% of participants) of overweight/obesity in the study population.12 months

Using biomarkers, self-report, and other physiological tests (i.e. BP screenings), researchers will assess the prevalence of co-morbid conditions.

Prevalence (% of participants) of tuberculosis in the study population.12 months

Using biomarkers, self-report, and other physiological tests (i.e. BP screenings), researchers will assess the prevalence of co-morbid conditions.

Trial Locations

Locations (9)

Ahero Sub District Hospital

🇰🇪

Ahero, Nyanza, Kenya

Ambira Sub District Hospital

🇰🇪

Ambira, Nyanza, Kenya

Awasi Mission

🇰🇪

Awasi, Nyanza, Kenya

Nyakach District Hospital

🇰🇪

Kisumu, Nyanza, Kenya

Masogo Sub District Hospital

🇰🇪

Masogo, Nyanza, Kenya

Nyangoma Dispensary

🇰🇪

Nyangoma, Nyanza, Kenya

Sigomere Health Centre

🇰🇪

Sigomere, Nyanza, Kenya

Sondu Health Center

🇰🇪

Sondu, Nyanza, Kenya

Bondo District Hospital

🇰🇪

Bondo, Nyanza, Kenya

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