@article{Castillo-Mancilla2021,
abstract = {Background: Lower antiretroviral therapy (ART) adherence is associated with higher systemic inflammation in virally suppressed people with HIV (PWH); however, previous studies have mostly relied on subjective adherence measures and have not assessed this association by disease stage upon ART initiation. Methods: In the Monitoring Early Treatment Adherence study, adherence was monitored electronically in real time among adult, treatment-na{\"{i}}ve PWH in Uganda and South Africa who initiated tenofovir disoproxil fumarate/emtricitabine/efavirenz during early-stage (CD4 {\textgreater} 350 cells/µL) or late-stage (CD4 {\textless} 200 cells/µL) disease. Participants who achieved viral suppression ({\textless} 400 copies/mL) at 6 months and remained suppressed after 12 months were analysed. The association between average ART adherence and plasma concentrations of interleukin 6 (IL-6), soluble CD14 (sCD14) and D-dimer was evaluated using adjusted multivariable linear regression, stratified by disease stage. Results: In all, 488 PWH (61{\%} women, mean age 35 years) were included in the analysis. Median ART adherence overall was 87{\%}. In adjusted models, every 10{\%} increase in average adherence was associated with a 3.0{\%} decrease in IL-6 [95{\%} confidence interval (CI): −5.9 to −0.01, p = 0.05] at 12 months. This relationship was observed in PWH with both early-stage (5.9{\%}, 95{\%} CI: −10.1 to −1.6, p = 0.009) and late-stage disease (3.7{\%}, 95{\%} CI: −7.2 to −0.2, p = 0.039). No significant associations were found with sCD14 or D-dimer. Conclusions: Objective ART adherence measurement was inversely associated with systemic inflammation in PWH who achieved viral suppression after ART initiation in sub-Saharan Africa, with a greater association in those with early-stage HIV. This finding underscores the importance of ART adherence beyond establishing viral suppression.},
author = {Castillo-Mancilla, J.R. and Musinguzi, N. and Asiimwe, S. and Siedner, M.J. and Orrell, C. and Bangsberg, D.R. and Haberer, J.E.},
doi = {10.1111/hiv.13200},
journal = {HIV Medicine},
title = {{High residual inflammation despite HIV viral suppression: Lessons learned from real-time adherence monitoring among people with HIV in Africa}},
year = {2021}
}

{"_id":"PahMwyozzvoJawvsJ","bibbaseid":"castillomancilla-musinguzi-asiimwe-siedner-orrell-bangsberg-haberer-highresidualinflammationdespitehivviralsuppressionlessonslearnedfromrealtimeadherencemonitoringamongpeoplewithhivinafrica-2021","author_short":["Castillo-Mancilla, J.","Musinguzi, N.","Asiimwe, S.","Siedner, M.","Orrell, C.","Bangsberg, D.","Haberer, J."],"bibdata":{"bibtype":"article","type":"article","abstract":"Background: Lower antiretroviral therapy (ART) adherence is associated with higher systemic inflammation in virally suppressed people with HIV (PWH); however, previous studies have mostly relied on subjective adherence measures and have not assessed this association by disease stage upon ART initiation. Methods: In the Monitoring Early Treatment Adherence study, adherence was monitored electronically in real time among adult, treatment-naïve PWH in Uganda and South Africa who initiated tenofovir disoproxil fumarate/emtricitabine/efavirenz during early-stage (CD4 \\textgreater 350 cells/µL) or late-stage (CD4 \\textless 200 cells/µL) disease. Participants who achieved viral suppression (\\textless 400 copies/mL) at 6 months and remained suppressed after 12 months were analysed. The association between average ART adherence and plasma concentrations of interleukin 6 (IL-6), soluble CD14 (sCD14) and D-dimer was evaluated using adjusted multivariable linear regression, stratified by disease stage. Results: In all, 488 PWH (61% women, mean age 35 years) were included in the analysis. Median ART adherence overall was 87%. In adjusted models, every 10% increase in average adherence was associated with a 3.0% decrease in IL-6 [95% confidence interval (CI): −5.9 to −0.01, p = 0.05] at 12 months. This relationship was observed in PWH with both early-stage (5.9%, 95% CI: −10.1 to −1.6, p = 0.009) and late-stage disease (3.7%, 95% CI: −7.2 to −0.2, p = 0.039). No significant associations were found with sCD14 or D-dimer. Conclusions: Objective ART adherence measurement was inversely associated with systemic inflammation in PWH who achieved viral suppression after ART initiation in sub-Saharan Africa, with a greater association in those with early-stage HIV. This finding underscores the importance of ART adherence beyond establishing viral suppression.","author":[{"propositions":[],"lastnames":["Castillo-Mancilla"],"firstnames":["J.R."],"suffixes":[]},{"propositions":[],"lastnames":["Musinguzi"],"firstnames":["N."],"suffixes":[]},{"propositions":[],"lastnames":["Asiimwe"],"firstnames":["S."],"suffixes":[]},{"propositions":[],"lastnames":["Siedner"],"firstnames":["M.J."],"suffixes":[]},{"propositions":[],"lastnames":["Orrell"],"firstnames":["C."],"suffixes":[]},{"propositions":[],"lastnames":["Bangsberg"],"firstnames":["D.R."],"suffixes":[]},{"propositions":[],"lastnames":["Haberer"],"firstnames":["J.E."],"suffixes":[]}],"doi":"10.1111/hiv.13200","journal":"HIV Medicine","title":"High residual inflammation despite HIV viral suppression: Lessons learned from real-time adherence monitoring among people with HIV in Africa","year":"2021","bibtex":"@article{Castillo-Mancilla2021,\nabstract = {Background: Lower antiretroviral therapy (ART) adherence is associated with higher systemic inflammation in virally suppressed people with HIV (PWH); however, previous studies have mostly relied on subjective adherence measures and have not assessed this association by disease stage upon ART initiation. Methods: In the Monitoring Early Treatment Adherence study, adherence was monitored electronically in real time among adult, treatment-na{\\\"{i}}ve PWH in Uganda and South Africa who initiated tenofovir disoproxil fumarate/emtricitabine/efavirenz during early-stage (CD4 {\\textgreater} 350 cells/µL) or late-stage (CD4 {\\textless} 200 cells/µL) disease. Participants who achieved viral suppression ({\\textless} 400 copies/mL) at 6 months and remained suppressed after 12 months were analysed. The association between average ART adherence and plasma concentrations of interleukin 6 (IL-6), soluble CD14 (sCD14) and D-dimer was evaluated using adjusted multivariable linear regression, stratified by disease stage. Results: In all, 488 PWH (61{\\%} women, mean age 35 years) were included in the analysis. Median ART adherence overall was 87{\\%}. In adjusted models, every 10{\\%} increase in average adherence was associated with a 3.0{\\%} decrease in IL-6 [95{\\%} confidence interval (CI): −5.9 to −0.01, p = 0.05] at 12 months. This relationship was observed in PWH with both early-stage (5.9{\\%}, 95{\\%} CI: −10.1 to −1.6, p = 0.009) and late-stage disease (3.7{\\%}, 95{\\%} CI: −7.2 to −0.2, p = 0.039). No significant associations were found with sCD14 or D-dimer. Conclusions: Objective ART adherence measurement was inversely associated with systemic inflammation in PWH who achieved viral suppression after ART initiation in sub-Saharan Africa, with a greater association in those with early-stage HIV. This finding underscores the importance of ART adherence beyond establishing viral suppression.},\nauthor = {Castillo-Mancilla, J.R. and Musinguzi, N. and Asiimwe, S. and Siedner, M.J. and Orrell, C. and Bangsberg, D.R. and Haberer, J.E.},\ndoi = {10.1111/hiv.13200},\njournal = {HIV Medicine},\ntitle = {{High residual inflammation despite HIV viral suppression: Lessons learned from real-time adherence monitoring among people with HIV in Africa}},\nyear = {2021}\n}\n","author_short":["Castillo-Mancilla, J.","Musinguzi, N.","Asiimwe, S.","Siedner, M.","Orrell, C.","Bangsberg, D.","Haberer, J."],"key":"Castillo-Mancilla2021","id":"Castillo-Mancilla2021","bibbaseid":"castillomancilla-musinguzi-asiimwe-siedner-orrell-bangsberg-haberer-highresidualinflammationdespitehivviralsuppressionlessonslearnedfromrealtimeadherencemonitoringamongpeoplewithhivinafrica-2021","role":"author","urls":{},"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://drive.google.com/uc?export=download&id=1-9gwO2GBrWfUK-fFo05cgfzXdRK_w9xL","dataSources":["wrEvssexmuYudwQw9","9bX4N36CTXtCXNFMd"],"keywords":[],"search_terms":["high","residual","inflammation","despite","hiv","viral","suppression","lessons","learned","real","time","adherence","monitoring","people","hiv","africa","castillo-mancilla","musinguzi","asiimwe","siedner","orrell","bangsberg","haberer"],"title":"High residual inflammation despite HIV viral suppression: Lessons learned from real-time adherence monitoring among people with HIV in Africa","year":2021}