Human Immunodeficiency Virus Is Associated With Higher Levels of Systemic Inflammation Among Kenyan Adults Despite Viral Suppression. (12th December 2020)

• Record Type: Journal Article
• Authors: Masyuko, Sarah J; Page, Stephanie T; Polyak, Stephen J; Kinuthia, John; Osoti, Alfred O; Otieno, Fredrick C; Kibachio, Joseph M; Mogaka, Jerusha N; Macharia, Paul M; Chohan, Bhavna H; Wogner, Jessica; O'Connor, Aidan; Temu, Tecla M; Zifodya, Jerry S; Otedo, Amos; Nakanjako, Damalie; Hughes, James P; Farquhar, Carey
• Is Part Of: Clinical infectious diseases. Volume 73:Number 7(2021)
• Page Start: e2034
• Page End: e2042
• Publication Date: 2020-12-12
• Subjects: HIV -- inflammation -- Kenya -- cardiovascular disease risk; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1650
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: 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. Abstract : Despite achieving viral suppression, people living with HIV (PLHIV) had higher levels of inflammatory markers compared with individuals without HIV, independent of cardiovascular disease risk factors. Further investigations to determine whether inflammatory biomarkers predict cardiovascular events among PLHIV are warranted.