Purpose: To evaluate the relationships among age-related macular degeneration (AMD), mortality, and biomarkers of systemic inflammation in patients with acquired immunodeficiency syndrome (AIDS). Design: Case-control study. Methods: In participants with intermediate-stage AMD at enrollment in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) and 2:1 controls matched for age and sex, cryopreserved baseline plasma specimens were assayed for biomarkers of inflammation, including high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, interferon-γ inducible protein (IP)-10, soluble CD14 (sCD14), soluble CD163 (sCD163), kynurenine/tryptophan (KT) ratio, and intestinal fatty acid binding protein (I-FABP). Main outcome measure was mortality. Results: The study included 189 patients with AMD and 385 controls. In the unadjusted analysis, AMD was associated with mortality (hazard ratio [HR] 1.48; 95% confidence interval [CI] 1.02, 2.15; P =.04). In an adjusted analysis, CRP (HR 1.36; 95% CI 1.08, 1.71; P =.009), IL-6 (HR 1.45; 95% CI 1.11, 1.90; P =.006), and IP-10 (HR 1.41; 95% CI 1.08, 1.84; P =.01) were associated with mortality. In a Cox regression analysis adjusted for human immunodeficiency virus load, blood CD4+ T cell level, CRP, IL-6, and IP-10, the association of AMD with mortality was attenuated (HR 1.08; 95% CI 0.73, 1.59; P =.70), primarily by the addition of the inflammatory biomarkers. Conclusions: These data suggest that the increased mortality observed in patients with AIDS with AMD is, at least in part, a result of systemic inflammation.
Bibliographical noteFunding Information:
Funding/Support: Supported by grant EY025093 from the National Eye Institute , the National Institutes of Health , Bethesda, Maryland, USA. Financial Disclosures: The following authors have no financial disclosures: Douglas A. Jabs, Mark L. Van Natta, Garrett Trang, Norman G. Jones, Jeffrey M. Milush, Ryan Cheu, Nichole R. Klatt, Ronald P. Danis, and Peter W. Hunt. All authors attest that they meet the current ICMJE criteria for authorship.
© 2018 Elsevier Inc.
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural