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Hermes DJ, Jacobs IR, Key MC, League AF, Yadav-Samudrala BJ, Xu C, McLane VD, Nass SR, Jiang W, Meeker RB, Ignatowska-Jankowska BM, Lichtman AH, Li Z, Wu Z, Yuan H, Knapp PE, Hauser KF, Fitting S. Escalating morphine dosing in HIV-1 Tat transgenic mice with sustained Tat exposure reveals an allostatic shift in neuroinflammatory regulation accompanied by increased neuroprotective non-endocannabinoid lipid signaling molecules and amino acids. J Neuroinflammation 2020; 17:345. [PMID: 33208151 PMCID: PMC7672881 DOI: 10.1186/s12974-020-01971-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus type-1 (HIV-1) and opiates cause long-term inflammatory insult to the central nervous system (CNS) and worsen disease progression and HIV-1-related neuropathology. The combination of these proinflammatory factors reflects a devastating problem as opioids have high abuse liability and continue to be prescribed for certain patients experiencing HIV-1-related pain. METHODS Here, we examined the impact of chronic (3-month) HIV-1 transactivator of transcription (Tat) exposure to short-term (8-day), escalating morphine in HIV-1 Tat transgenic mice that express the HIV-1 Tat protein in a GFAP promoter-regulated, doxycycline (DOX)-inducible manner. In addition to assessing morphine-induced tolerance in nociceptive responses organized at spinal (i.e., tail-flick) and supraspinal (i.e., hot-plate) levels, we evaluated neuroinflammation via positron emission tomography (PET) imaging using the [18F]-PBR111 ligand, immunohistochemistry, and cytokine analyses. Further, we examined endocannabinoid (eCB) levels, related non-eCB lipids, and amino acids via mass spectrometry. RESULTS: Tat-expressing [Tat(+)] transgenic mice displayed antinociceptive tolerance in the tail withdrawal and hot-plate assays compared to control mice lacking Tat [Tat(-)]. This tolerance was accompanied by morphine-dependent increases in Iba-1 ± 3-nitrotryosine immunoreactive microglia, and alterations in pro- and anti-inflammatory cytokines, and chemokines in the spinal cord and striatum, while increases in neuroinflammation were absent by PET imaging of [18F]-PBR111 uptake. Tat and morphine exposure differentially affected eCB levels, non-eCB lipids, and specific amino acids in a region-dependent manner. In the striatum, non-eCB lipids were significantly increased by short-term, escalating morphine exposure, including peroxisome proliferator activator receptor alpha (PPAR-α) ligands N-oleoyl ethanolamide (OEA) and N-palmitoyl ethanolamide (PEA), as well as the amino acids phenylalanine and proline. In the spinal cord, Tat exposure increased amino acids leucine and valine, while morphine decreased levels of tyrosine and valine but did not affect eCBs or non-eCB lipids. CONCLUSION Overall results demonstrate that 3 months of Tat exposure increased morphine tolerance and potentially innate immune tolerance evidenced by reductions in specific cytokines (e.g., IL-1α, IL-12p40) and microglial reactivity. In contrast, short-term, escalating morphine exposure acted as a secondary stressor revealing an allostatic shift in CNS baseline inflammatory responsiveness from sustained Tat exposure.
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Affiliation(s)
- Douglas J Hermes
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Ian R Jacobs
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Megan C Key
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Alexis F League
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | | | - Changqing Xu
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Virginia D McLane
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sara R Nass
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA
- Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Rick B Meeker
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Aron H Lichtman
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Zibo Li
- Department of Radiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Zhanhong Wu
- Department of Radiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Hong Yuan
- Department of Radiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Pamela E Knapp
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Anatomy & Neurobiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kurt F Hauser
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Anatomy & Neurobiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Sylvia Fitting
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
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2
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Idrisov B, Lunze K, Cheng DM, Blokhina E, Gnatienko N, Quinn E, Bridden C, Walley AY, Bryant KJ, Lioznov D, Krupitsky E, Samet JH. Role of substance use in HIV care cascade outcomes among people who inject drugs in Russia. Addict Sci Clin Pract 2017; 12:30. [PMID: 29198185 PMCID: PMC5713116 DOI: 10.1186/s13722-017-0098-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 11/08/2017] [Indexed: 12/11/2022] Open
Abstract
Background Engaging people who drink alcohol or inject drugs in HIV care can be challenging, particularly in Eastern Europe. Healthcare facilities in Russia are organized by specialty; therefore linking patients from addiction care to HIV hospitals has been difficult. The HIV care cascade outlines stages of HIV care (e.g., linkage to care, prescribed antiretroviral therapy [ART], and achieving HIV viral suppression). We hypothesized that unhealthy alcohol use, injection drug use, and opioid craving are associated with unfavorable HIV care cascade outcomes. Methods We analyzed data from a cohort (n = 249) of HIV-positive Russians who have been in addiction hospital treatment in the past year and had a lifetime history of injection drug use (IDU). We evaluated the association between unhealthy alcohol use (AUDIT score > 7 [both hazardous drinking and dependence]), past-month injection drug use (IDU), and opioid craving (visual analogue scale from 1 to 100) with HIV care cascade outcomes. The primary outcome was linkage to HIV care within 12 months. Other outcomes were prescription of ART (secondary) and achievement of undetectable HIV viral load (HVL < 500 copies/mL) within 12 months (exploratory); the latter was analyzed on a subset in which HVL was measured (n = 48). We assessed outcomes via medical record review (linkage, ART) and serum tests (HVL). To examine the primary outcome, we used multiple logistic regression models controlling for potential confounders. Results Among 249 study participants, unhealthy alcohol use (n = 148 [59%]) and past-month IDU (n = 130 [52%]) were common. The mean opioid craving score was 49 (SD: 38). We were unable to detect significant associations between the independent variables (i.e., unhealthy alcohol use, IDU and opioid craving) and any HIV care cascade outcomes in unadjusted and adjusted analyses. Conclusion In this cohort of HIV-positive Russians with a history of IDU, individual substance use factors were not significantly associated with achieving HIV care cascade milestones (i.e., linkage to HIV care; prescription for ART; or suppressed viral load). Given no detection of an association of cascade outcomes with recent unhealthy use of alcohol or injection drugs in this cohort, examining systemic factors to understand determinants of HIV care engagement for people with drug use would be important.
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Affiliation(s)
- Bulat Idrisov
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA.,Department of Infectious Diseases, Bashkir State Medical University, 3 Lenina St., Ufa, Bashkortostan Republic, Russian Federation, 450000
| | - Karsten Lunze
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA.,Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA
| | - Debbie M Cheng
- Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA, 02118, USA
| | - Elena Blokhina
- First St. Petersburg Pavlov State Medical University, Lev Tolstoy St. 6/8, St. Petersburg, Russian Federation, 197022
| | - Natalia Gnatienko
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA
| | - Emily Quinn
- Data Coordinating Center, Boston University School of Public Health, 85 E Newton St M921, Boston, MA, 02118, USA
| | - Carly Bridden
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA
| | - Alexander Y Walley
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA
| | - Kendall J Bryant
- HIV/AIDS Research, National Institute on Alcohol Abuse and Alcoholism, National Institute of Health, 5365 Fishers Lane, Bethesda, MD, 20892, USA
| | - Dmitry Lioznov
- First St. Petersburg Pavlov State Medical University, Lev Tolstoy St. 6/8, St. Petersburg, Russian Federation, 197022.,Pasteur Research Institute of Epidemiology and Microbiology, Mira St. 14, St. Petersburg, Russian Federation, 197101
| | - Evgeny Krupitsky
- First St. Petersburg Pavlov State Medical University, Lev Tolstoy St. 6/8, St. Petersburg, Russian Federation, 197022.,St. Petersburg Bekhterev Research Psychoneurological Institute, Bekhtereva St., 3, St. Petersburg, Russian Federation, 192019
| | - Jeffrey H Samet
- Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA, 02118, USA. .,Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, Boston, MA, 02118, USA.
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3
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Scott-Sheldon LAJ, Carey KB, Johnson BT, Carey MP. Behavioral Interventions Targeting Alcohol Use Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis. AIDS Behav 2017; 21:126-143. [PMID: 28831609 PMCID: PMC5660648 DOI: 10.1007/s10461-017-1886-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Alcohol use is often reported among people living with HIV/AIDS (PLWHA) and is associated with increased sexual risk and poor medication adherence. This meta-analysis evaluated the efficacy of behavioral interventions addressing alcohol use among PLWHA. Twenty-one studies (N = 8461 PLWHA) that evaluated an individual-level intervention addressing alcohol use alone or as part of a more comprehensive alcohol/HIV intervention, included a control condition, and were available through December 2016 were included. Independent raters coded study, sample, and intervention content. Weighted mean effect sizes, using random-effects models, were calculated. Results indicate that interventions reduced alcohol consumption, increased condom use, and improved medication adherence relative to controls (d +s = 0.10-0.24). Plasma viral load was also reduced in intervention versus control participants (d + = 0.14, 95% CI = 0.02, 0.26; k = 7). These findings show that behavioral interventions addressing alcohol use can successfully reduce alcohol consumption and also improve HIV-related outcomes among PLWHA.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA.
- Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI, USA.
| | - Kate B Carey
- Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, RI, USA
| | - Blair T Johnson
- Department of Psychology, University of Connecticut, Storrs, CT, USA
| | - Michael P Carey
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, CORO Building, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Alpert School of Medicine, Brown University, Providence, RI, USA
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4
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Gaskill PJ, Miller DR, Gamble-George J, Yano H, Khoshbouei H. HIV, Tat and dopamine transmission. Neurobiol Dis 2017; 105:51-73. [PMID: 28457951 PMCID: PMC5541386 DOI: 10.1016/j.nbd.2017.04.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/04/2017] [Accepted: 04/16/2017] [Indexed: 01/02/2023] Open
Abstract
Human Immunodeficiency Virus (HIV) is a progressive infection that targets the immune system, affecting more than 37 million people around the world. While combinatorial antiretroviral therapy (cART) has lowered mortality rates and improved quality of life in infected individuals, the prevalence of HIV associated neurocognitive disorders is increasing and HIV associated cognitive decline remains prevalent. Recent research has suggested that HIV accessory proteins may be involved in this decline, and several studies have indicated that the HIV protein transactivator of transcription (Tat) can disrupt normal neuronal and glial function. Specifically, data indicate that Tat may directly impact dopaminergic neurotransmission, by modulating the function of the dopamine transporter and specifically damaging dopamine-rich regions of the CNS. HIV infection of the CNS has long been associated with dopaminergic dysfunction, but the mechanisms remain undefined. The specific effect(s) of Tat on dopaminergic neurotransmission may be, at least partially, a mechanism by which HIV infection directly or indirectly induces dopaminergic dysfunction. Therefore, precisely defining the specific effects of Tat on the dopaminergic system will help to elucidate the mechanisms by which HIV infection of the CNS induces neuropsychiatric, neurocognitive and neurological disorders that involve dopaminergic neurotransmission. Further, this will provide a discussion of the experiments needed to further these investigations, and may help to identify or develop new therapeutic approaches for the prevention or treatment of these disorders in HIV-infected individuals.
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Affiliation(s)
- Peter J Gaskill
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA 19102, United States.
| | - Douglas R Miller
- Department of Neuroscience, University of Florida, Gainesville, FL 32611, United States
| | - Joyonna Gamble-George
- Department of Neuroscience, University of Florida, Gainesville, FL 32611, United States
| | - Hideaki Yano
- National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, United States
| | - Habibeh Khoshbouei
- Department of Neuroscience, University of Florida, Gainesville, FL 32611, United States.
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5
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Impact of illicit opioid use on T cell subsets among HIV-infected adults. PLoS One 2017; 12:e0176617. [PMID: 28472064 PMCID: PMC5417591 DOI: 10.1371/journal.pone.0176617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 04/13/2017] [Indexed: 12/18/2022] Open
Abstract
Objectives Opioids have immunosuppressive properties, yet opioid effects on T cell abnormalities consistent with the immune risk phenotype among HIV-infected individuals are understudied. Methods To assess associations between illicit opioid use and T cell characteristics (CD4/CD8 ratio, memory profiles based on CD45RO and CD28 expression, and senescence based on CD57 expression), we conducted an exploratory cross-sectional analysis of Russia ARCH, a cohort of antiretroviral therapy (ART)-naïve HIV-infected individuals recruited 11/2012 to 10/2014 in St. Petersburg, Russia. The main independent variable was past 30 day illicit opioid use (yes vs. no). Secondary analyses evaluated none (0 days), intermittent (1 to 7 days), and persistent (8 to 30 days) opioid use. Outcomes were determined with flow cytometry. Analyses were conducted using linear regression models. Results Among 186 participants, 38% reported any illicit opioid use (18% intermittent and 20% persistent). Any illicit opioid use was not significantly associated with T cell characteristics. Intermittent opioid use appeared to be associated with decreased memory CD8+ T cells proportion (CD45RO+CD45RA- CD8+ T cells: adjusted mean difference [AMD] [95% CI] = -6.15 [-11.50, -0.79], p = 0.02) and borderline significant increased senescent T cells (%CD57+ of total CD28-CD8+ T cells (AMD [95% CI] = 7.70 [-0.06, 15.46], p = 0.05). Conclusions Among ART-naïve HIV-infected Russians, any illicit opioid use was not significantly associated with T cell abnormalities although intermittent illicit opioid use may be associated with CD8 T cell abnormalities. Longitudinal studies are warranted to confirm these findings given increased risk of infections and comorbidities seen among HIV-infected individuals with illicit opioid use.
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6
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Edelman EJ, Gordon KS, Tate JP, Becker WC, Bryant K, Crothers K, Gaither JR, Gibert CL, Gordon AJ, Marshall B, Rodriguez-Barradas MC, Samet JH, Skanderson M, Justice AC, Fiellin DA. The impact of prescribed opioids on CD4 cell count recovery among HIV-infected patients newly initiating antiretroviral therapy. HIV Med 2016; 17:728-739. [PMID: 27186715 PMCID: PMC5053822 DOI: 10.1111/hiv.12377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Certain prescribed opioids have immunosuppressive properties, yet their impact on clinically relevant outcomes, including antiretroviral therapy (ART) response among HIV-infected patients, remains understudied. METHODS Using the Veterans Aging Cohort Study data, we conducted a longitudinal analysis of 4358 HIV-infected patients initiating ART between 2002 and 2010 and then followed them for 24 months. The primary independent variable was prescribed opioid duration, categorized using pharmacy data as none prescribed, short-term (< 90 days) and long-term (≥ 90 days). Outcomes included CD4 cell count over time. Analyses adjusted for demographics, comorbid conditions, ART type and year of initiation, and overall disease severity [ascertained with the Veterans Aging Cohort Study (VACS) Index]. Sensitivity analyses examined whether effects varied according to baseline CD4 cell count, achievement of viral load suppression, and opioid properties (i.e. dose and known immunosuppressive properties). RESULTS Compared to those with none, patients with short-term opioids had a similar increase in CD4 cell count (mean rise per year: 74 vs. 68 cells/μL; P = 0.11), as did those with long-term prescribed opioids (mean rise per year: 74 vs. 75 cells/μL; P = 0.98). In sensitivity analysis, compared with no opioids, the effects of short-term prescribed opioids were statistically significant among those with a baseline CD4 cell count ≥ 500 cells/μL (mean rise per year: 52 cells/μL for no opioids vs. 20 cells/μL for short-term opioids; P = 0.04); findings were otherwise unchanged. CONCLUSIONS Despite immunosuppressive properties intrinsic to opioids, prescribed opioids appeared to have no effect on CD4 cell counts over 24 months among HIV-infected patients initiating ART.
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Affiliation(s)
- E J Edelman
- Yale University School of Medicine, New Haven, CT, USA.
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA.
| | - K S Gordon
- VA Connecticut Health Care System, West Haven, CT, USA
| | - J P Tate
- Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Health Care System, West Haven, CT, USA
| | - W C Becker
- Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Health Care System, West Haven, CT, USA
| | - K Bryant
- National Institute on Alcohol Abuse and Alcoholism, HIV/AIDS Program, Bethesda, MD, USA
| | - K Crothers
- University of Washington, Seattle, WA, USA
| | - J R Gaither
- Yale University School of Medicine, New Haven, CT, USA
- VA Connecticut Health Care System, West Haven, CT, USA
- Yale University School of Public Health, New Haven, CT, USA
| | - C L Gibert
- DC Veterans Affairs Medical Center and George Washington University, Washington, DC, USA
| | - A J Gordon
- Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA, USA
| | - Bdl Marshall
- Brown University School of Public Health, Providence, RI, USA
| | - M C Rodriguez-Barradas
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - J H Samet
- Boston University Schools of Medicine and Public Health, Boston, MA, USA
| | - M Skanderson
- VA Connecticut Health Care System, West Haven, CT, USA
| | - A C Justice
- Yale University School of Medicine, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
- VA Connecticut Health Care System, West Haven, CT, USA
| | - D A Fiellin
- Yale University School of Medicine, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
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7
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Ndombi EM, Budambula V, Webale MK, Musumba FO, Wesongah JO, Mibei E, Ahmed AA, Lihana R, Were T. Serum adiponectin in HIV-1 and hepatitis C virus mono- and co-infected Kenyan injection drug users. Endocr Connect 2015; 4:223-32. [PMID: 26306727 PMCID: PMC4566843 DOI: 10.1530/ec-15-0071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/25/2015] [Indexed: 01/18/2023]
Abstract
Adiponectin is an important marker of anthropometric profiles of adipose tissue. However, association of adiponectin and adiposity in HIV mono- and co-infected and hepatitis (HCV) injection drug users (IDUs) has not been elucidated. Therefore, the relationship of total adiponectin levels with anthropometric indices of adiposity was examined in HIV mono-infected (anti-retroviral treatment, ART-naive, n=16 and -experienced, n=34); HCV mono-infected, n=36; HIV and HCV co-infected (ART-naive, n=5 and -experienced, n=13); uninfected, n=19 IDUs; and healthy controls, n=16 from coastal Kenya. Anthropometric indices of adiposity were recorded and total circulating adiponectin levels were measured in serum samples using enzyme-linked immunosorbent assay. Adiponectin levels differed significantly amongst the study groups (P<0.0001). Post-hoc analyses revealed decreased levels in HIV mono-infected ART-naive IDUs in comparison to uninfected IDUs (P<0.05) and healthy controls (P<0.05). However, adiponectin levels were elevated in HCV mono-infected IDUs relative to HIV mono-infected ART-naive (P<0.001) and -experienced (P<0.001) as well as HIV and HCV co-infected ART-naive (P<0.05) IDUs. Furthermore, adiponectin correlated with weight (ρ=0.687; P=0.003) and BMI (ρ=0.598; P=0.014) in HIV mono-infected ART-naive IDUs; waist circumference (ρ=-0.626; P<0.0001), hip (ρ=-0.561; P=0.001) circumference, and bust-to-waist ratio (ρ=0.561; P=0.001) in HIV mono-infected ART-experienced IDUs; waist girth (ρ=0.375; P=0.024) in HCV mono-infected IDUs; and waist-to-hip ratio (ρ=-0.872; P=0.048) in HIV and HCV co-infected ART-naive IDUs. Altogether, these results suggest suppression of adiponectin production in treatment-naive HIV mono-infected IDUs and that circulating adiponectin is a useful surrogate marker of altered adiposity in treatment-naive and -experienced HIV and HCV mono- and co-infected IDUs.
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Affiliation(s)
- Eric M Ndombi
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Valentine Budambula
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Mark K Webale
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Francis O Musumba
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Jesca O Wesongah
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Erick Mibei
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Aabid A Ahmed
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Raphael Lihana
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
| | - Tom Were
- Bomu HospitalMombasa, KenyaDepartment of PathologyKenyatta University, Nairobi, KenyaDepartment of Environment and Health SciencesTechnical University of Mombasa, Mombasa, KenyaDepartment of Biomedical Sciences and TechnologyMaseno University, Maseno, KenyaDepartment of Medical Laboratory SciencesJomo Kenyatta University of Agriculture and Technology, Juja, KenyaKapkatet CampusUniversity of Kabianga, Kericho, KenyaCentre for Virus ResearchKenya Medical Research Institute, Nairobi, KenyaDepartment of Medical Laboratory SciencesMasinde Muliro University of Science and Technology, Post Box 190-50100 Kakamega, Kenya
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8
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Chen L, Yang J, Zhang R, Xu Y, Zheng J, Jiang J, Jiang J, He L, Wang N, Yeung PC, Pan X. Rates and risk factors associated with the progression of HIV to AIDS among HIV patients from Zhejiang, China between 2008 and 2012. AIDS Res Ther 2015; 12:32. [PMID: 26413133 PMCID: PMC4582728 DOI: 10.1186/s12981-015-0074-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 09/16/2015] [Indexed: 12/16/2022] Open
Abstract
Objectives The objective of this study was to determine the rate of acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify specific factors associated with progression of this disease. Methods This study utilized a retrospective cohort to identify the specific factors involved in the progression of human immunodeficiency virus (HIV) to AIDS. We collected data of patients existing in care between 2008 and 2012 from the national surveillance system databases. We performed our analyses using a multivariate Cox proportional hazards model. Results This study included 9216 HIV-positive patients (75.6 % male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 % (2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ2 = 4341.9, P < 0.001). The cumulative AIDS progression incidence rates were 33.4, 35.4, 36.4, 37.0 and 37.04 per 100 py in 1 each of the 5 years of follow-up. This study found that age was an independent risk factor for the progression of HIV to AIDS. Compared with patients infected with HIV by homosexual transmission, patients infected with HIV by heterosexuals transmission or blood transfusion had a reduced hazard ratio (HR) for progression to AIDS (heterosexual transmission: HR = 0.695, 0.524, P = 0.007; blood transfusion: HR = 0.524, P = 0.015). Diagnosed with HIV from 2011 to 2012 and having a higher CD4+ cell count (350–500 cells/mm3; or >500 cells/mm3) at baseline were independently associated with lower rates of HIV progression to AIDS [HR = 0.382, 0.380, 0.187, P < 0.001]. Patients with a CD+ T-cell count of 200–350 cells/mm3 or greater than 350 cells/mm3 were less likely to develop AIDS following HIV diagnosis than were those patients without HAART treatment. Conclusion This study found a high progression rate from HIV to AIDS in HIV patients residing within Zhejiang province from 2008 to 2010. This rate decreased after 2010, which coincided with the new criteria for HAART treatment, which likely contributed to the observed reduction in the rate of progression. Initiation of HAART with higher CD4+ T-cell count may reduce rate of AIDS progression. Based on our results, we conclude that efficient strategies for HIV screening, as well as early diagnosis and treatment are necessary to reduce the progression of HIV to AIDS.
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