Factors Associated With Plasma IL-6 Levels During HIV Infection

Álvaro H Borges; Jemma L O'Connor; Andrew N Phillips; Frederikke F Rönsholt; Sarah Pett; Michael J Vjecha; Martyn A French; Jens D Lundgren; INSIGHT SMART and ESPRIT Study Groups and the SILCAAT Scientific Committee

doi:10.1093/infdis/jiv123

Factors Associated With Plasma IL-6 Levels During HIV Infection

Álvaro H Borges, Jemma L O'Connor, Andrew N Phillips, Frederikke F Rönsholt, Sarah Pett, Michael J Vjecha, Martyn A French, Jens D Lundgren, INSIGHT SMART and ESPRIT Study Groups and the SILCAAT Scientific Committee

Department of Clinical Medicine

63 Citations (Scopus)

Abstract

BACKGROUND: Elevated interleukin 6 (IL-6) levels have been linked to cardiovascular disease, cancer and death. Persons with human immunodeficiency virus (HIV) infection receiving treatment have higher IL-6 levels, but few data are available on factors associated with circulating IL-6.

METHODS: Participants in 3 trials with IL-6 measured at baseline were included (N = 9864). Factors associated with IL-6 were identified by linear regression. Demographic and HIV variables (nadir/entry CD4(+) cell count, HIV RNA level, antiretroviral therapy regimen) were investigated in all 3 trials. In the SMART (Strategies for Management of Anti-Retroviral Therapy) trial, CD4/CD8 ratio, smoking, comorbid conditions, serum lipids, renal function (estimated glomerular filtration rate [eGFR]), and educational level were assessed.

RESULTS: Demographics associated with higher IL-6 levels were older age and lower education, whereas black race was associated with lower IL-6. Higher HIV RNA levels were associated with higher IL-6 levels, and higher nadir CD4(+) cell counts with lower IL-6 levels. Compared with efavirenz, protease inhibitors were associated with higher and nevirapine with lower IL-6 levels. Smoking and all comorbid conditions were related to higher IL-6. IL-6 levels increased with decreasing eGFR and decreasing serum lipids.

CONCLUSIONS: Higher levels of IL-6 were associated with older age, nonblack race, higher body mass index, lower serum lipid levels, HIV replication, low nadir CD4(+) cell count, protease inhibitor use, comorbid conditions, and decreased eGFR. Multiple factors affect inflammation in HIV and should be considered in studies of IL-6 as a biomarker of clinical outcomes.

Original language	English
Journal	The Journal of Infectious Diseases
Volume	212
Issue number	4
Pages (from-to)	585-95
Number of pages	11
ISSN	0022-1899
DOIs	https://doi.org/10.1093/infdis/jiv123
Publication status	Published - 15 Aug 2015

Keywords

Adult
Biomarkers
Cross-Sectional Studies
Female
Fibrin Fibrinogen Degradation Products
HIV Infections
Humans
Inflammation
Interleukin-6
Male
Middle Aged
RNA, Viral
Smoking
Viral Load

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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@article{d8a1b7c2f3b347eab0d885f12cf3210e,

title = "Factors Associated With Plasma IL-6 Levels During HIV Infection",

abstract = "BACKGROUND: Elevated interleukin 6 (IL-6) levels have been linked to cardiovascular disease, cancer and death. Persons with human immunodeficiency virus (HIV) infection receiving treatment have higher IL-6 levels, but few data are available on factors associated with circulating IL-6.METHODS: Participants in 3 trials with IL-6 measured at baseline were included (N = 9864). Factors associated with IL-6 were identified by linear regression. Demographic and HIV variables (nadir/entry CD4(+) cell count, HIV RNA level, antiretroviral therapy regimen) were investigated in all 3 trials. In the SMART (Strategies for Management of Anti-Retroviral Therapy) trial, CD4/CD8 ratio, smoking, comorbid conditions, serum lipids, renal function (estimated glomerular filtration rate [eGFR]), and educational level were assessed.RESULTS: Demographics associated with higher IL-6 levels were older age and lower education, whereas black race was associated with lower IL-6. Higher HIV RNA levels were associated with higher IL-6 levels, and higher nadir CD4(+) cell counts with lower IL-6 levels. Compared with efavirenz, protease inhibitors were associated with higher and nevirapine with lower IL-6 levels. Smoking and all comorbid conditions were related to higher IL-6. IL-6 levels increased with decreasing eGFR and decreasing serum lipids.CONCLUSIONS: Higher levels of IL-6 were associated with older age, nonblack race, higher body mass index, lower serum lipid levels, HIV replication, low nadir CD4(+) cell count, protease inhibitor use, comorbid conditions, and decreased eGFR. Multiple factors affect inflammation in HIV and should be considered in studies of IL-6 as a biomarker of clinical outcomes.",

keywords = "Adult, Biomarkers, Cross-Sectional Studies, Female, Fibrin Fibrinogen Degradation Products, HIV Infections, Humans, Inflammation, Interleukin-6, Male, Middle Aged, RNA, Viral, Smoking, Viral Load",

author = "Borges, {{\'A}lvaro H} and O'Connor, {Jemma L} and Phillips, {Andrew N} and R{\"o}nsholt, {Frederikke F} and Sarah Pett and Vjecha, {Michael J} and French, {Martyn A} and Lundgren, {Jens D} and {INSIGHT SMART and ESPRIT Study Groups and the SILCAAT Scientific Committee}",

note = "{\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].",

year = "2015",

month = aug,

day = "15",

doi = "10.1093/infdis/jiv123",

language = "English",

volume = "212",

pages = "585--95",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "4",

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TY - JOUR

T1 - Factors Associated With Plasma IL-6 Levels During HIV Infection

AU - Borges, Álvaro H

AU - O'Connor, Jemma L

AU - Phillips, Andrew N

AU - Rönsholt, Frederikke F

AU - Pett, Sarah

AU - Vjecha, Michael J

AU - French, Martyn A

AU - Lundgren, Jens D

AU - INSIGHT SMART and ESPRIT Study Groups and the SILCAAT Scientific Committee

PY - 2015/8/15

Y1 - 2015/8/15

N2 - BACKGROUND: Elevated interleukin 6 (IL-6) levels have been linked to cardiovascular disease, cancer and death. Persons with human immunodeficiency virus (HIV) infection receiving treatment have higher IL-6 levels, but few data are available on factors associated with circulating IL-6.METHODS: Participants in 3 trials with IL-6 measured at baseline were included (N = 9864). Factors associated with IL-6 were identified by linear regression. Demographic and HIV variables (nadir/entry CD4(+) cell count, HIV RNA level, antiretroviral therapy regimen) were investigated in all 3 trials. In the SMART (Strategies for Management of Anti-Retroviral Therapy) trial, CD4/CD8 ratio, smoking, comorbid conditions, serum lipids, renal function (estimated glomerular filtration rate [eGFR]), and educational level were assessed.RESULTS: Demographics associated with higher IL-6 levels were older age and lower education, whereas black race was associated with lower IL-6. Higher HIV RNA levels were associated with higher IL-6 levels, and higher nadir CD4(+) cell counts with lower IL-6 levels. Compared with efavirenz, protease inhibitors were associated with higher and nevirapine with lower IL-6 levels. Smoking and all comorbid conditions were related to higher IL-6. IL-6 levels increased with decreasing eGFR and decreasing serum lipids.CONCLUSIONS: Higher levels of IL-6 were associated with older age, nonblack race, higher body mass index, lower serum lipid levels, HIV replication, low nadir CD4(+) cell count, protease inhibitor use, comorbid conditions, and decreased eGFR. Multiple factors affect inflammation in HIV and should be considered in studies of IL-6 as a biomarker of clinical outcomes.

AB - BACKGROUND: Elevated interleukin 6 (IL-6) levels have been linked to cardiovascular disease, cancer and death. Persons with human immunodeficiency virus (HIV) infection receiving treatment have higher IL-6 levels, but few data are available on factors associated with circulating IL-6.METHODS: Participants in 3 trials with IL-6 measured at baseline were included (N = 9864). Factors associated with IL-6 were identified by linear regression. Demographic and HIV variables (nadir/entry CD4(+) cell count, HIV RNA level, antiretroviral therapy regimen) were investigated in all 3 trials. In the SMART (Strategies for Management of Anti-Retroviral Therapy) trial, CD4/CD8 ratio, smoking, comorbid conditions, serum lipids, renal function (estimated glomerular filtration rate [eGFR]), and educational level were assessed.RESULTS: Demographics associated with higher IL-6 levels were older age and lower education, whereas black race was associated with lower IL-6. Higher HIV RNA levels were associated with higher IL-6 levels, and higher nadir CD4(+) cell counts with lower IL-6 levels. Compared with efavirenz, protease inhibitors were associated with higher and nevirapine with lower IL-6 levels. Smoking and all comorbid conditions were related to higher IL-6. IL-6 levels increased with decreasing eGFR and decreasing serum lipids.CONCLUSIONS: Higher levels of IL-6 were associated with older age, nonblack race, higher body mass index, lower serum lipid levels, HIV replication, low nadir CD4(+) cell count, protease inhibitor use, comorbid conditions, and decreased eGFR. Multiple factors affect inflammation in HIV and should be considered in studies of IL-6 as a biomarker of clinical outcomes.

KW - Adult

KW - Biomarkers

KW - Cross-Sectional Studies

KW - Female

KW - Fibrin Fibrinogen Degradation Products

KW - HIV Infections

KW - Humans

KW - Inflammation

KW - Interleukin-6

KW - Male

KW - Middle Aged

KW - RNA, Viral

KW - Smoking

KW - Viral Load

U2 - 10.1093/infdis/jiv123

DO - 10.1093/infdis/jiv123

M3 - Journal article

C2 - 25722296

SN - 0022-1899

VL - 212

SP - 585

EP - 595

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 4

ER -

Factors Associated With Plasma IL-6 Levels During HIV Infection

Abstract

Keywords

UN SDGs

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