2
|
Osuna-Padilla IA, Rodríguez-Moguel NC, Aguilar-Vargas A, Rodríguez-Aguirre E, Briceño O, Ávila-Ríos S. Normal weight obesity is associated with hypercholesterolemia and low muscle mass in persons living with HIV on antiretroviral treatment. Nutrition 2021; 94:111515. [PMID: 34844155 DOI: 10.1016/j.nut.2021.111515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/22/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Normal weight obesity (NWO) is defined as a condition of normal body weight, but with high body fat percentage. Clinical and immunologic implications of NWO in persons living with HIV (PLHIV) remain unknown. The aim of this study was to examine NWO prevalence and its associations with metabolic and immunologic measurements in a cohort of PLHIV on antiretroviral treatment (ART). METHODS We enrolled 73 adult PLHIV on ART. Body composition was assessed by dual-energy x-ray absorptiometry. NWO was defined as body mass index 18.5 to 24.9 kg/m2 and body fat ≥25%. We determined triacylglycerols, total cholesterol, high-density lipoprotein, low-density lipoprotein, blood glucose, blood pressure, bone mineral density, inflammatory cytokines (interleukin [IL]-1β, tumor necrosis factor-α and IL-6) and CD4+ and CD8+ T-cell activation. RESULTS The prevalence of NWO was 49% (36 of 73). Participants with NWO showed lower CD4+ T-cell percentage (25 versus 27%, P = 0.03), lower CD4/CD8 ratio (0.62 versus 0.82, P = 0.02), lower muscle mass (6.84 versus 7.11 kg/m2, P = 0.01) and higher prevalence of hypercholesterolemia (26% versus 6%, P = 0.03) than individuals with normal body composition. No differences in inflammation/activation markers were observed between groups (P > 0.05 in all cases). CONCLUSION NWO was frequent in a cohort of Mexican PLHIV on ART and was associated with lower muscle mass, hypercholesterolemia, lower CD4+ T-cell percentage, and lower CD4/CD8 ratio. The incorporation of body fat measurements in the regular physical examination of PLHIV could contribute to early identification of the NWO condition and lead to better management of possible long-term morbidity.
Collapse
Affiliation(s)
- Ivan A Osuna-Padilla
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Nadia C Rodríguez-Moguel
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Adriana Aguilar-Vargas
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Edna Rodríguez-Aguirre
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Olivia Briceño
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| |
Collapse
|
3
|
Bares SH, Smeaton LM, Scott SE, Smith BA, Godfrey C, McComsey GA. The Association Between Weight Gain, Sex and Immune Activation Following the Initiation of Antiretroviral Therapy. J Infect Dis 2021; 224:1765-1774. [PMID: 33870433 DOI: 10.1093/infdis/jiab210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/16/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Immune activation persists despite suppressive antiretroviral therapy (ART) and may be affected by sex or body composition. We explored these relationships in a subset of participants who initiated ART in two large randomized trials. METHODS Purposeful sampling selected participants who achieved virologic suppression on ART and either maintained weight within +/- 0.5 kg/m 2 or gained 2.6-6.4 kg/m 2 from baseline to 96 weeks. We measured 7 markers of inflammation and immune activation at weeks 0 and 96. Multivariable linear regression explored associations of weight gain, sex, and pre-ART BMI with pre-ART and changes in biomarker concentrations. RESULTS 340 participants were selected; median pre-ART age 42 years, CD4+ cell count 273 cells/mm 3, HIV-1 RNA 4.7 log10 copies/mL; 49% were women, 33% white, 42% black, and 24% Hispanic. Among participants with a normal pre-ART BMI, higher pre-ART levels of IL-6, sTNF-RI and RII, CXCL-10, sCD163 and hsCRP were associated with weight gain. Association of weight gain with week 96 changes of these biomarkers differed by sex; women who gained weight had smaller declines in most measured biomarkers compared to men who gained. CONCLUSIONS Among women, weight gain is associated with attenuated decline in several immune activation markers following ART initiation.
Collapse
Affiliation(s)
- Sara H Bares
- University of Nebraska Medical Center, Omaha, NE, U.S
| | | | - Sarah E Scott
- University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, U.S
| | - Beth A Smith
- University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, U.S
| | - Catherine Godfrey
- Office of the Global AIDS Coordinator, Department of State, Washington D.C., U.S
| | - Grace A McComsey
- University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, U.S
| |
Collapse
|
4
|
Cyktor JC, Bosch RJ, Mar H, Macatangay BJ, Collier AC, Hogg E, Godfrey C, Eron JJ, McMahon DK, Mellors JW, Gandhi RT. Association of Male Sex and Obesity With Residual Plasma Human Immunodeficiency Virus 1 Viremia in Persons on Long-Term Antiretroviral Therapy. J Infect Dis 2021; 223:462-470. [PMID: 32603416 DOI: 10.1093/infdis/jiaa373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although adipose tissue has been proposed to harbor part of the human immunodeficiency virus 1 (HIV-1) reservoir, the influence of host characteristics, including sex and body mass index (BMI), on measures of HIV-1 persistence during antiretroviral therapy (ART) are incompletely understood. METHODS We evaluated age, sex, BMI, waist circumference, years on ART, pre-ART HIV-1 RNA, pre-ART CD4+ T-cell count, and initial ART regimen with measures of HIV-1 persistence in blood (residual viremia, cellular HIV-1 DNA and RNA) in a cohort of 295 individuals with well-documented long-term virologic suppression (HIV-1 RNA <50 copies/mL) on ART (AIDS Clinical Trials Group study A5321). RESULTS Men were more likely than women to have detectable plasma HIV-1 RNA by single-copy assay (52% vs 29%; P = .003), and the proportion of participants with detectable residual viremia increased in a stepwise fashion by BMI category (normal weight or underweight, 38%; overweight, 50%; and obese, 55%). ART regimen type was not associated with measures of HIV-1 persistence after controlling for ART duration. CONCLUSIONS Sex and obesity are independently associated with residual viremia in people on long-term ART. Additional studies to confirm these relationships and to define the mechanisms by which sex and obesity affect HIV-1 persistence are needed to inform HIV-1 cure strategies.
Collapse
Affiliation(s)
| | - Ronald J Bosch
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Hanna Mar
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | | | - Evelyn Hogg
- Social & Scientific Systems, Silver Spring, Maryland, USA
| | - Catherine Godfrey
- Office of the Global AIDS Coordinator Department of State, Washington DC, USA
| | - Joseph J Eron
- University of North Carolina, Chapel Hill, North Carolina, USA
| | | | | | - Rajesh T Gandhi
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | |
Collapse
|
5
|
Wanjalla CN, Mashayekhi M, Bailin S, Gabriel CL, Meenderink LM, Temu T, Fuller DT, Guo L, Kawai K, Virmani R, Jenkins C, Abana CO, Warren CM, Gangula R, Smith R, Madhur MS, Finn AV, Gelbard AH, Su YR, Tyska MJ, Kalams SA, Harrison DG, Mallal SA, Absi TS, Beckman JA, Koethe JR. Anticytomegalovirus CD4 + T Cells Are Associated With Subclinical Atherosclerosis in Persons With HIV. Arterioscler Thromb Vasc Biol 2021; 41:1459-1473. [PMID: 33567869 DOI: 10.1161/atvbaha.120.315786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Celestine N Wanjalla
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Mona Mashayekhi
- Division of Diabetes, Endocrinology and Metabolism (M.M.), Vanderbilt University Medical Center, Nashville
| | - Samuel Bailin
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Curtis L Gabriel
- Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Division of Gastroenterology (C.L.G., ), Vanderbilt University Medical Center, Nashville
| | - Leslie M Meenderink
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, TN (L.M.M.).,Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN (L.M.M., J.R.K.)
| | - Tecla Temu
- Department of Global Health, University of Washington, Seattle (T.T.)
| | | | - Liang Guo
- CVPath Institute, Gaithersburg, MD (D.T.F., L.G., K.K., R.V.)
| | - Kenji Kawai
- CVPath Institute, Gaithersburg, MD (D.T.F., L.G., K.K., R.V.)
| | - Renu Virmani
- CVPath Institute, Gaithersburg, MD (D.T.F., L.G., K.K., R.V.)
| | - Cathy Jenkins
- Department of Biostatistics (C.J.), Vanderbilt University Medical Center, Nashville
| | - Chike O Abana
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston (C.O.A.)
| | - Christian M Warren
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Rama Gangula
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Rita Smith
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Meena S Madhur
- Division of Clinical Pharmacology (M.S.M., D.G.H.), Vanderbilt University Medical Center, Nashville
| | | | - Alexander H Gelbard
- Department of Otolaryngology (A.H.G., S.A.M.), Vanderbilt University Medical Center, Nashville
| | - Yan Ru Su
- Division of Cardiovascular Medicine (Y.R.S., J.A.B.), Vanderbilt University Medical Center, Nashville
| | | | - Spyros A Kalams
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Department of Otolaryngology (A.H.G., S.A.M.), Vanderbilt University Medical Center, Nashville.,Vanderbilt Technologies for Advanced Genomics (VANTAGE) (S.A.M.), Vanderbilt University Medical Center, Nashville
| | - David G Harrison
- Division of Clinical Pharmacology (M.S.M., D.G.H.), Vanderbilt University Medical Center, Nashville
| | - Simon A Mallal
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville
| | - Tarek S Absi
- Department of Cardiac Surgery (T.S.A.), Vanderbilt University Medical Center, Nashville
| | - Joshua A Beckman
- Division of Cardiovascular Medicine (Y.R.S., J.A.B.), Vanderbilt University Medical Center, Nashville
| | - John R Koethe
- Division of Infectious Diseases (C.N.W., S.B., L.M.M., C.M.W., R.G., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Tennessee Center for AIDS Research (C.N.W., C.L.G., C.M.W., R.S., S.A.K., S.A.M., J.R.K.), Vanderbilt University Medical Center, Nashville.,Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN (L.M.M., J.R.K.)
| |
Collapse
|
6
|
Masenga SK, Elijovich F, Hamooya BM, Nzala S, Kwenda G, Heimburger DC, Mutale W, Munsaka SM, Zhao S, Koethe JR, Kirabo A. Elevated Eosinophils as a Feature of Inflammation Associated With Hypertension in Virally Suppressed People Living With HIV. J Am Heart Assoc 2020; 9:e011450. [PMID: 32064996 PMCID: PMC7070208 DOI: 10.1161/jaha.118.011450] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background People living with HIV (PLWH) are at increased risk of cardiovascular disease, including hypertension, which persists despite effective plasma viral suppression on antiretroviral therapy. HIV infection is characterized by long‐term alterations in immune function, but the contribution of immune factors to hypertension in PLWH is not fully understood. Prior studies have found that both innate and adaptive immune cell activation contributes to hypertension. Methods and Results We hypothesized that chronic inflammation may contribute to hypertension in PLWH. To test this hypothesis, we enrolled a cohort of 70 PLWH (44% hypertensive) on a long‐term single antiretroviral therapy regimen for broad phenotyping of inflammation biomarkers. We found that hypertensive PLWH had higher levels of inflammatory cytokines, including tumor necrosis factor‐α receptor 1, interleukin‐6, interleukin‐17, interleukin‐5, intercellular adhesion molecule 1 and macrophage inflammatory protein‐1α. After adjustment for age, sex, and fat mass index, the circulating eosinophils remained significantly associated with hypertension. On the basis of these results, we assessed the relationship of eosinophils and hypertension in 2 cohorts of 50 and 81 039 similar HIV‐negative people; although eosinophil count was associated with prevalent hypertension, this relationship was abrogated by body mass index. Conclusions These findings may represent a unique linkage between immune status and cardiovascular physiological characteristics in HIV infection, which should be evaluated further.
Collapse
Affiliation(s)
- Sepiso K Masenga
- School of Medicine and Health Sciences Mulungushi University Livingstone Zambia.,Department of Biomedical Sciences School of Health Sciences University of Zambia Lusaka Zambia.,Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville TN
| | - Fernando Elijovich
- Division of Clinical Pharmacology Vanderbilt University Medical Center Nashville TN
| | - Benson M Hamooya
- School of Medicine and Health Sciences Mulungushi University Livingstone Zambia.,Department of Epidemiology and Biostatistics School of Public Health University of Zambia Lusaka Zambia
| | - Selestine Nzala
- Department of Medical Education Development University of Zambia Lusaka Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences School of Health Sciences University of Zambia Lusaka Zambia
| | - Douglas C Heimburger
- Vanderbilt Institute for Global Health Vanderbilt University Medical Center Nashville TN
| | - Wilbroad Mutale
- Department of Health Policy and Management School of Public Health University of Zambia Lusaka Zambia
| | - Sody M Munsaka
- Department of Biomedical Sciences School of Health Sciences University of Zambia Lusaka Zambia
| | - Shilin Zhao
- Department of Biostatistics Vanderbilt University Medical Center Nashville TN
| | - John R Koethe
- Division of Infectious Diseases Vanderbilt University Medical Center Nashville TN
| | - Annet Kirabo
- Division of Clinical Pharmacology Vanderbilt University Medical Center Nashville TN.,Department of Molecular Physiology and Biophysics Vanderbilt University Nashville TN
| |
Collapse
|