HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer

Barbara S. Taylor, Kaku So-Armah, Janet P. Tate, Vincent C. Marconi, John R. Koethe, Roger J. Bedimo, Adeel A. Butt, Cynthia L. Gibert, Matthew B. Goetz, Maria C. Rodriguez-Barradas, Julie A. Womack, Mariana Gerschenson, Vincent Lo Re, David Rimland, Michael T. Yin, David Leaf, Russell P. Tracy, Amy C. Justice, Matthew S. Freiberg

Research output: Contribution to journalArticle

Abstract

Objectives: Obesity prevalence among people living with HIV (HIV+) is rising. HIV and obesity are proinflammatory states, but their combined effect on inflammation (measured by interleukin 6, IL-6), altered coagulation (D-dimer), and monocyte activation (soluble CD14, sCD14) is unknown. We hypothesized inflammation increases when obesity and HIV infection co-occur. Methods: The Veterans Aging Cohort Study survey cohort is a prospective, observational study of predominantly male HIV+ veterans and veterans uninfected with HIV; a subset provided blood samples. Inclusion criteria for this analysis were body mass index ≥ 18.5 kg/m2 and biomarker measurement. Dependent variables were IL-6, sCD14, and D-dimer quartiles. Obesity/HIV status was the primary predictor. Unadjusted and adjusted logistic regression models were constructed. Results: Data were analyzed for 1477 HIV+ and 823 uninfected participants. Unadjusted median IL-6 levels were significantly higher and sCD14 levels significantly lower in obese/HIV+ compared with nonobese/uninfected (P <0.01 for both). In adjusted analyses, the odds ratio for increased IL-6 in obese/HIV+ patients was 1.76 (95% confidence interval: 1.18 to 2.47) compared with nonobese/uninfected, and obesity/HIV+ remained associated with lower odds of elevated sCD14. We did not detect a synergistic association of co-occurring HIV and obesity on IL-6 or sCD14 elevation. D-dimer levels did not differ significantly between body mass index/HIV status groups. Conclusions: HIV-obesity comorbidity is associated with elevated IL-6, decreases in sCD14, and no significant difference in D-dimer. These findings are clinically significant, as previous studies associated these biomarkers with mortality. Future studies should assess whether other biomarkers show similar trends and potential mechanisms for unanticipated sCD14 and D-dimer findings.

Original languageEnglish (US)
Pages (from-to)500-508
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Volume75
Issue number5
DOIs
StatePublished - Aug 15 2017

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Keywords

  • coagulation
  • HIV
  • inflammation
  • monocyte activation
  • obesity
  • VACS

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Taylor, B. S., So-Armah, K., Tate, J. P., Marconi, V. C., Koethe, J. R., Bedimo, R. J., Butt, A. A., Gibert, C. L., Goetz, M. B., Rodriguez-Barradas, M. C., Womack, J. A., Gerschenson, M., Lo Re, V., Rimland, D., Yin, M. T., Leaf, D., Tracy, R. P., Justice, A. C., & Freiberg, M. S. (2017). HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer. Journal of Acquired Immune Deficiency Syndromes, 75(5), 500-508. https://doi.org/10.1097/QAI.0000000000001444