Human Immunodeficiency Virus Is Associated With Higher Levels of Systemic Inflammation Among Kenyan Adults Despite Viral Suppression
Autor: | Jessica Wogner, Jerry S Zifodya, Aidan O’Connor, Damalie Nakanjako, John Kinuthia, Tecla M Temu, James P. Hughes, Stephanie T. Page, Paul Macharia, Jerusha N Mogaka, Alfred Osoti, Amos Otedo, Bhavna Chohan, Sarah Masyuko, Stephen J. Polyak, Joseph Kibachio, Carey Farquhar, Fredrick C Otieno |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty HIV Infections Inflammation Disease 030204 cardiovascular system & hematology Systemic inflammation 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine medicine Humans Online Only Articles Aged business.industry HIV Interleukin medicine.disease Kenya Obesity Cross-Sectional Studies 030104 developmental biology Infectious Diseases Tumor necrosis factor alpha medicine.symptom business Viral load Biomarkers |
Zdroj: | Clin Infect Dis |
ISSN: | 1537-6591 1058-4838 |
Popis: | Background Systemic inflammation independently predicts future cardiovascular events and is associated with a 2-fold increase in cardiovascular disease (CVD) risk among persons living with human immunodeficiency virus (PLHIV). We examined the association between inflammatory markers, HIV status, and traditional CVD risk factors. Methods We conducted a cross-sectional study of Kenyan adults with and without HIV seeking care at Kisumu County Hospital. Using a multiplex immunoassay, we measured interleukin (IL) 1β, IL-6, tumor necrosis factor α (TNF-α), and high-sensitivity C-reactive protein (hsCRP) concentrations. We compared inflammatory marker concentrations by HIV status using the Wilcoxon rank-sum test. Multivariable linear regression was used to evaluate associations between inflammatory biomarkers and HIV status, adjusting for CVD risk factors. Results We enrolled 286 PLHIV and 277 HIV-negative participants. Median duration of antiretroviral therapy for PLHIV was 8 years (interquartile range, 4–10) and 96% were virally suppressed. PLHIV had a 51% higher mean IL-6 concentration (P < .001), 39% higher mean IL-1β (P = .005), 40% higher mean TNF-α (P < .001), and 27% higher mean hsCRP (P = .008) compared with HIV-negative participants, independent of CVD risk factors. Male sex, older age, and obesity were associated with higher concentrations of inflammatory markers. Restricting to PLHIV, viral load of ≥1000 copies/mL was associated with higher TNF-α levels (P = .013). Conclusions We found higher levels of systemic inflammatory biomarkers among PLHIV who were virally suppressed, and this was independent of traditional CVD risk factors. Further longitudinal analyses to determine whether these inflammatory markers predict future CVD events, and are possible therapeutic targets among PLHIV, are warranted. |
Databáze: | OpenAIRE |
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