1071. Comparison of Inflammatory Biomarkers and Immune Activation with Comorbid Conditions in a Kenyan Population Based Upon HIV Status and Treatment
Session: Poster Abstract Session: HIV: Basic Science and Pathogenesis
Friday, October 9, 2015
Room: Poster Hall
Background: Individuals infected with HIV have ongoing systemic inflammation.  Persistently elevated inflammatory markers have been linked to increased morbidity and mortality in the HIV-infected population independent of comorbid conditions.  However, effects of co-infections and comorbidities on these biomarkers in HIV-1 have not been robustly studied in the developing world.

Methods: Luminex xMAP® multiplex assay and ELISA were performed on cryopreserved serum from 76 Kenyan men and women who are HIV-uninfected, infected not on antiretroviral therapy (ART), and infected on ART to quantify immunologic biomarkers.  Measures of inflammation (high sensitivity interleukin-6 (IL-6), high-sensitive C-reactive protein (CRP), matrix metalloproteinases [MMPs]); immune activation (tumor necrosis factor-α [TNF-α]); gut epithelial cell death (intestinal fatty acid binding protein [IFABP]); and monocyte activation (sCD14, sCD163) were compared between groups after assessing for confounding comorbidities. 

Results: HIV-infected participants had higher levels of MMP-1, MMP-7, TNF-α, sCD14, IL-6 and sCD163 (all p<0.05) compared to uninfected controls. Among HIV-infected individuals, MMP-1, MMP-7, TNF-α, sCD14, IL-6 were lower (all p<0.05) while sCD163 (p<0.05) and IL-6 (p<0.14) were higher in participants on ART compared to those not receiving therapy. Individuals with a CD4 count <200 cells/µL demonstrated elevated IL-6 (odds ratio [OR], 2.38; 95% confidence interval [CI] 0.42-13.4) and TNF-α (OR, 6.66; 95% CI, 1.14-38.8) when compared to uninfected study participants.  No significant differences were observed in MMP-2, MMP-9, IFABP, and Fas ligand between these two groups.  HIV-infected and uninfected groups had similar rates of alcohol and cigarette use, hepatitis, hypertension, renal disease, syphilis, and BMI, but the HIV-infected group showed higher rates of impaired fasting glucose and elevated cholesterol.

Conclusion: Similar to larger studies performed in the developed world, HIV infection is associated with inflammation, immune activation, and monocyte activation in a Kenyan population compared to a community matched HIV-uninfected population with similar comorbid disease burden.

Andrew Letizia, MD1, Michael Eller, PhD2, Leigh Anne Eller, MD2, Matthew Creegan, MS2, Eric Rono, MD3, Jonah Maswai, MD3, Rither Langat, MD3 and Julie Ake, MD, MSc2, (1)Infectious Disease, Walter Reed National Military Medical Center, Bethesda, MD, (2)US Military HIV Research Program (MHRP) at WRAIR, Silver Spring, MD, (3)KEMRI/Walter Reed Project, Kericho, Kenya, Kericho, Kenya


A. Letizia, None

M. Eller, None

L. A. Eller, None

M. Creegan, None

E. Rono, None

J. Maswai, None

R. Langat, None

J. Ake, None

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