Objective:

This study aimed to investigate the association between inflammatory biomarkers and comorbidities in PWH.

Background:

PWH have elevated rates of comorbidities, such as dyslipidemia, metabolic syndrome (MetS), neuropathic pain (NPP), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM). Inflammation has been associated with chronic comorbid diseases. This study evaluated the cross-sectional association between inflammatory biomarkers and comorbidities in PWH and people without HIV (PWoH) in the CHARTER Study.

Design/Methods:

Plasma samples were assessed in a group of 261 participants (110 PWH and 151 PWoH, 26% female, 15% Black, mean age 43 years), while CSF samples were assessed in a separate group of 264 participants (126 PWH and 131 PWoH, 20% female, 15% Black, mean age 38 years). In plasma group, levels of 8-Oxo-deoxyguanosine, IL-6, IL-8, MCP1, uPAR, VEGF, and IP10 were measured. In CSF group, levels of MCP1, soluble TNF-alpha receptor-II (sTNFRII), TNF-alpha, MIP1-β, and sCD14 were assessed. A multivariate logistic regression model was used to identify the association between the biomarkers and comorbidities.

Results:

In plasma group, the median current CD4+ T-cell count was 307/µL (IQR), compared to 326/µL in CSF group. Virally suppressed individuals made up 77% of the plasma group and 44% of the CSF group. In both groups, PWH had a higher prevalence of NPP, dyslipidemia, and COPD (p<0.05). After adjusting for age, sex, viral load, and HIV status, elevated plasma IL-8 and uPAR levels were linked to NPP, MetS, and DM. Additionally, higher levels of CSF sCD14 and MIP-1β were associated with NPP (log-OR [95%CI]: 0.45 [0.12-0.82]).

Conclusions:

These findings highlight the role of systemic inflammation and immune activation in the pathogenesis of comorbidities in PWH. Targeting inflammation could be a critical strategy for mitigating long-term health risks in PWH. Further exploration of the mechanisms linking specific biomarkers to different comorbidities could inform the development of tailored treatments.