Lee, SulggiByakwaga, HelenBoum, YapBurdo, Tricia H.Williams, Kenneth C.Lederman, Michael M.Huang, YongTracy, Russell P.Cao, HuyenHaberer, Jessica E.Kembabazi, AnnetBangsberg, David R.Martin, Jeffrey N.Hunt, Peter W.2022-01-312022-01-312017Lee, S., Byakwaga, H., Boum, Y., Burdo, T. H., Williams, K. C., Lederman, M. M., ... & Hunt, P. W. (2017). Immunologic pathways that predict mortality in HIV-infected Ugandans initiating antiretroviral therapy. The Journal of infectious diseases, 215(8), 1270-1274. DOI: 10.1093/infdis/jix11310.1093/infdis/jix113https://nru.uncst.go.ug/xmlui/handle/123456789/1672The plasma kynurenine/tryptophan (KT) ratio, a marker of adaptive immune defects, strongly predicts mortality during treated human immunodeficiency virus (HIV) disease in Ugandans as compared to US-based populations. Here, the KT ratio and T-cell and plasma biomarkers of immune activation were measured among 535 HIV-infected Ugandans prior to ART initiation and at month 6 of viral suppression. The month 6 KT ratio (adjusted hazard ratio [aHR], 2.74), soluble CD14 level (aHR, 2.32), interleukin 6 level (aHR, 2.34), and D-dimer level (aHR, 1.95) were associated with mortality occurring ≥6 months after ART initiation. The KT ratio remained significantly predictive of mortality even after adjustment for the additional biomarkers, suggesting an independent contribution to clinical outcomes in resource-limited settings.enHIVKynurenineTryptophanD-dimerIL-6; sCD14MortalityAntiretroviral therapyAfricaArticle