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.
L. A. Eller, None
M. Creegan, None
E. Rono, None
J. Maswai, None
R. Langat, None
J. Ake, None