{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:10:54Z","timestamp":1786979454442,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,5,30]],"date-time":"2019-05-30T00:00:00Z","timestamp":1559174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009780","name":"Region Sk\u00e5ne","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The clinical significance of low\u2010level viraemia (<jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content>) during antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) is debated. We retrospectively investigated longitudinal levels of plasma markers associated with inflammation, altered coagulation and cardiovascular disease in Swedish <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive adults in relation to <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> or permanent virological suppression during long\u2010term <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma levels of C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>), D\u2010dimer, vascular cell adhesion molecule 1 (<jats:styled-content style=\"fixed-case\">VCAM<\/jats:styled-content>\u20101), suppression of tumorigenicity 2 (<jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>2), growth differentiation factor 15 (<jats:styled-content style=\"fixed-case\">GDF<\/jats:styled-content>\u201015), soluble CD14 (<jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>14), soluble CD163 (<jats:styled-content style=\"fixed-case\">sCD<\/jats:styled-content>163), interferon\u2010\u03b3\u2010induced protein 10 (<jats:styled-content style=\"fixed-case\">IP<\/jats:styled-content>\u201010) and \u03b2\u20102\u2010microglobulin were measured in 34 individuals with <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> (viral load 50\u2013999 HIV\u20101 RNA copies\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>) and in matched controls with persistent virological suppression. Biomarker levels were analysed in samples obtained during episodes of <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> and follow\u2010up samples obtained 1\u00a0year later (with similar timing for controls). All biomarkers were analysed using an independent sample <jats:italic>t<\/jats:italic>\u2010test and analysis of covariance (ANCOVA) after logarithmic transformation. Log\u2010rank analysis was applied for markers with concentration values out of range.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with controls, patients with <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> had significantly higher levels of <jats:styled-content style=\"fixed-case\">GDF<\/jats:styled-content>\u201015 [geometric mean 3416 (95% confidence interval (CI) 804\u201314\u00a0516) pg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> versus 2002 (95% CI 355\u201311\u00a0295) pg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> in controls; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.026] and D\u2010dimer [mean 1114 (95% CI 125\u20139917) ng\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> versus 756 (95% CI 157\u20133626) ng\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.038] after adjustment for age, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count nadir and type of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>. In the unadjusted <jats:italic>t<\/jats:italic>\u2010test, only <jats:styled-content style=\"fixed-case\">GDF<\/jats:styled-content>\u201015 was significantly higher and in the log\u2010rank test, both <jats:styled-content style=\"fixed-case\">GDF<\/jats:styled-content>\u201015 and D\u2010dimer were significantly elevated. No significant differences were observed for the other biomarkers analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although levels of inflammation markers were similar in <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> recipients with and without <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content>, persons with <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> had significantly higher levels of <jats:styled-content style=\"fixed-case\">GDF<\/jats:styled-content>\u201015 and D\u2010dimer. These findings suggest a potential link between <jats:styled-content style=\"fixed-case\">LLV<\/jats:styled-content> and cardiovascular outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.12756","type":"journal-article","created":{"date-parts":[[2019,5,31]],"date-time":"2019-05-31T07:05:32Z","timestamp":1559286332000},"page":"571-580","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Is low\u2010level <scp>HIV<\/scp>\u20101 viraemia associated with elevated levels of markers of immune activation, coagulation and cardiovascular disease?"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-9869","authenticated-orcid":false,"given":"O","family":"Elvstam","sequence":"first","affiliation":[{"name":"Department of Translational Medicine Lund University Malm\u00f6 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