Author:
Mwakyandile Tosi M.,Shayo Grace A.,Sasi Philip G.,Mugusi Ferdinand M.,Barabona Godfrey,Ueno Takamasa,Lyamuya Eligius F.
Abstract
Abstract
Background
The pathogenesis of hypertension (HTN) in people living with HIV/AIDS (PLHIV) is complex and remains not fully understood. Chronic immune activation (IA) is postulated to be one of the culprits. This notion is derived from studies in HIV-uninfected populations and/or animals while data on HTN and how it relates to IA in PLHIV remains scarce. We determined the relationship between HTN and IA among antiretroviral therapy (ART) naïve PLHIV.
Methods
We analysed baseline data of 365 out of 430 clinical trial participants whose main aim was to investigate the effect of low-dose aspirin on HIV disease progression in PLHIV starting ART. Soluble CD14 (sCD14), T cells co-expressing CD38 and HLA-DR, and PD-1 were the IA and exhaustion markers, respectively studied and were analysed by flow cytometry. Mann-Whitney U-test was used for comparison of the markers by HTN status. A robust Poisson regression model was used to determine the predictors for HTN.
Results
A quarter of the 365 were hypertensive (25.3%, 95% CI 20.9–29.8%), and, had higher median (IQR) body mass index (kg/m2) (23.4 (19.6, 28.0) versus 21.9 (19.3, 25.1)) and lower median (IQR) estimated glomerular filtration rate (mL/min/1.73m2) (101.2 (79.4, 126.9) versus 113.6 (92.7, 138.8)) than normotensive participants (p < 0.05). Participants with HTN had higher median frequencies of all markers of IA and exhaustion but lower sCD14 (p > 0.05). None of these markers significantly predicted the occurrence of HTN.
Conclusion
Studied markers of IA and exhaustion were higher in PLHIV with HTN than those without but were unpredictive of HTN. Larger multicentre studies with a wider range of markers are needed to confirm the role of IA in HIV-associated HTN.
Funder
Fogarty International Center (FIC) of the National Institutes of Health (NIH) through the Transforming Health Education in Tanzania (THET) project
Swedish International Development Cooperation Agency
Japan Student Service Organization
Fogarty International Center (FIC) of the National Institutes of Health
JSPS KAKENHI Grant-in-Aid for Scientific Research
JSPS Bilateral Open Partnership Joint Research Project
JSPS Core-to-Core Program
Publisher
Springer Science and Business Media LLC
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