Brief Report: Systemic Inflammation, Immune Activation, and Impaired Lung Function Among People Living with HIV in Rural Uganda

Details

• Personal Author:
  Christiani, David C. ; Hunt PW ; Kakuhikire B ; Kwon DS ; Muyanja D ; North CM ; Okello S ; Siedner MJ ; Tracy RP ; Tsai AC
• Description:
  Background: Although both chronic lung disease and HIV are inflammatory diseases common in sub-Saharan Africa, the relationship between systemic inflammation and lung function among people living with HIV (PLWH) in sub-Saharan Africa is not well described. Methods: We measured lung function (using spirometry) and serum high sensitivity C-reactive protein, interleukin 6 (IL-6), soluble CD14 (sCD14), and soluble CD163 (sCD163) in 125 PLWH on stable antiretroviral therapy (ART) and 109 age- and sex-similar HIV-uninfected control subjects in rural Uganda. We modeled the relationship between lung function and systemic inflammation using linear regression, stratified by HIV serostatus, controlled for age, sex, height, tobacco, and biomass exposure. Results: Half of subjects [46% (107/234)] were women, and the median age was 52 years (interquartile range: 48-55). Most PLWH [92% (115/125)] were virologically suppressed on first-line ART. Median CD4 count was 472 cells/mm3. In multivariable linear regression models stratified by HIV serostatus, an interquartile range increase in IL-6 and sCD163 were each inversely associated with lung function (mL, 95% confidence interval) among PLWH [IL-6: forced expiratory volume in 1 second (FEV1) -18.1 (-29.1 to -7.1), forced vital capacity (FVC) -17.1 (-28.2 to -5.9); sCD163: FVC -14.3 (-26.9 to -1.7)]. High sensitivity C-reactive protein (>3 vs. <1 mg/L) was inversely associated with lung function among both PLWH and HIV-uninfected control subjects [PLWH: FEV1 -39.3 (-61.7 to -16.9), FVC -44.0 (-48.4 to -6.4); HIV-uninfected: FEV1 -37.9 (-63.2 to -12.6), FVC -58.0 (-88.4 to -27.5)]. sCD14 was not associated with lung function, and all interaction terms were insignificant. Conclusions: Macrophage activation and systemic inflammation are associated with lower lung function among PLWH on stable ART in rural Uganda. Future work should focus on underlying mechanisms and public health implications. [Description provided by NIOSH]
• Subjects:
  Chronic Disease HIV Immune System Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Africa Author Keywords: AIDS Biomarker Chronic Diseases Human Immunodeficiency Virus Immune Reaction Immune System Disorders Lung Disease Respiratory Spirometry
• ISSN:
  1525-4135
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Massachusetts ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 9 ; Vermont ; Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  78
• Issue:
  5
• NIOSHTIC Number:
  nn:20056490
• Citation:
  JAIDS J Acquir Immune Defic Syndr 2018 Aug; 78(5):543-548
• Contact Point Address:
  Crystal M. North, MD, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 55 Fruit Street, BUL-148, Boston, MA 02114
• Email:
  cnorth@mgh.harvard.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  Harvard School of Public Health
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  JAIDS, Journal of Acquired Immune Deficiency Syndromes
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0830df736a3bf1293562a0ead8aec578e362fa7ebc84b2cd572e750a2fd32b3986e79500eb75fe9b1870ec03fbe2b1fd4746e7f5131dd8fdfee45e51337ca19e
• Download URL:
  https://stacks.cdc.gov/view/cdc/214090/cdc_214090_DS1.pdf
• File Type:
  [PDF - 116.71 KB ]