Inflammatory Markers and Plasma Lipids in HIV Patients: A Correlation Analysis Study



Rudo Muswe1, Olav Oktedalen2, Danai T. Zhou3, *, Enita Zinyando1, Sandra Shawarira-Bote4, Babill Stray-Pedersen5, Atipa Siziba6, Zvenyika A.R. Gomo1
1 Department of Chemical Pathology, University of Zimbabwe, Harare, Zimbabwe
2 Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway
3 Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe
4 Newlands - Clinic Harare, Harare, Zimbabwe
5 University of Oslo, Division of Women and Children, Oslo, Norway
6 Controlnet Consulting - Consultants Midrand, Gauteng, South Africa


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© 2017 Muswe et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe; Tel: +263772566214; E-mail: danaizh@yahoo.co.uk


Abstract

Background:

Recent evidence suggests that HIV infection, even with treatment, increases the risk of coronary heart disease (CHD) and that both chronic inflammation and traditional risk factors play key roles in HIV-associated CHD.

Subjects and Methods:

Patients (N=152), attending Harare HIV clinic, 26% of them male and 82% of them on antiretroviral therapy (ART), were studied. Inflammatory markers comprising of cytokines such as pro-inflammatory tumor necrosis factor-α, (TNF-α), anti-inflammatory interleukin 10, (IL-10) and highly sensitive C reactive protein (hsCRP) together with lipids were assayed using enzyme linked immunosorbent assay (ELISA), immuno-turbidimetric and enzymatic assays, respectively. Correlation analysis of inflammatory markers versus lipid profiles was carried out using bivariate regression analysis.

Results:

Anti-inflammatory cytokine IL-10 and inflammatory hsCRP levels were elevated when measured in all the HIV positive patients, while TNF-α and lipid levels were within normal ranges. Pro-inflammatory TNF-α was significantly higher in ART-naive patients than ART-experienced patients, whereas the reverse was observed for anti-inflammatory IL-10 and anti-atherogenic HDL-C. Correlation analysis indicated a significant positive linear association between IL-10 and total cholesterol (TC) levels but no other correlations were found.

Conclusion:

High cytokine ratio (TNF-α/IL-10) indicates higher CHD risk in ART-naive patients compared to the ART-exposed. The CHD risk could be further strengthened by interplay between inflammatory markers and high prevalence of low HDL-C. Lack of correlation between pro-inflammatory markers (hsCRP and TNF-α) with lipid fractions and correlation between anti-inflammatory IL-10 with artherogenic TC were unexpected findings, necessitating further studies in future.

Keywords: ART, CHD, Cytokines, HIV, HsCRP, IL-10, Inflammation, Lipids, TNF-alpha.