Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status
Background Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts m...
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| Veröffentlicht in: | PloS one 2021-08, Vol.16 (8), p.e0256576-e0256576, Article 0256576 |
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| creator | Kelly, Christine Tinago, Willard Alber, Dagmar Hunter, Patricia Luckhurst, Natasha Connolly, Jake Arrigoni, Francesca Garcia Abner, Alejandro Kamn'gona, Raphael Sheha, Irene Chammudzi, Mishek Jambo, Kondwani Mallewa, Jane Rapala, Alicja Mallon, Patrick W. G. Mwandumba, Henry Klein, Nigel Khoo, Saye |
| description | Background Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. Methods We recruited Malawian adults with CD4 |
| doi_str_mv | 10.1371/journal.pone.0256576 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8386842</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A673168812</galeid><doaj_id>oai_doaj_org_article_e459fd4cf6414d23a2795eb8f0b90b54</doaj_id><sourcerecordid>A673168812</sourcerecordid><originalsourceid>FETCH-LOGICAL-c641t-3197e5de79f3e2bf49f694b30513ca318dddc5e41fe644fe903729db1c4c5973</originalsourceid><addsrcrecordid>eNqNk11rFDEUhgdRbK3-A9EBQRTZNZlkvm6EsqhdqBS09DZkMiezKZlknGS67r83406XHelFyUVC8pz35HxF0WuMlpjk-POtHXrD9bKzBpYoSbM0z55Ep7gkySJLEHl6dD6JXjh3i1BKiix7Hp0QSklSJMVp1KyN1Lxtubf9Lu6432z5zsW8taZxPu7Adhpire6UaeKt8pv4Yn0TKxP_4JpvVVwrKaGPuRC2r0fG29hZoSwIa2yrROw894N7GT2TXDt4Ne1n0fW3r9eri8Xl1ff16vxyITKK_YLgMoe0hryUBJJK0lJmJa0ISjERnOCirmuRAsUSMkollIjkSVlXWFCRljk5i97uZTttHZtS5FjIDqU5LWgRiPWeqC2_ZV2vWt7vmOWK_buwfcN475XQwICmpaypkOFrtE4IT_IyhaqQqCpRldKg9WXyNlQt1AKM77meic5fjNqwxt6xItShoEkQ-DAJ9Pb3AM6zVjkBWnMDdtj_u0wRRiSg7_5DH45uohoeAlBG2uBXjKLsPMsJzooCj26XD1Bh1RAqFvpJqnA_M_g4MwiMhz--4YNzbP3r5-PZq5s5-_6I3QDXfuOsHryyxs1BugdFb53rQR6SjBEbx-E-G2wcBzaNQzB7c1ygg9F9_wfg0x7YQmWlEwqMgAOGEArdhXOchxMe6eLx9EqFxg9xrOxgPPkLVe4muw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2564474848</pqid></control><display><type>article</type><title>Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS) Journals Open Access</source><source>Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Kelly, Christine ; Tinago, Willard ; Alber, Dagmar ; Hunter, Patricia ; Luckhurst, Natasha ; Connolly, Jake ; Arrigoni, Francesca ; Garcia Abner, Alejandro ; Kamn'gona, Raphael ; Sheha, Irene ; Chammudzi, Mishek ; Jambo, Kondwani ; Mallewa, Jane ; Rapala, Alicja ; Mallon, Patrick W. G. ; Mwandumba, Henry ; Klein, Nigel ; Khoo, Saye</creator><contributor>Uthman, Olalekan</contributor><creatorcontrib>Kelly, Christine ; Tinago, Willard ; Alber, Dagmar ; Hunter, Patricia ; Luckhurst, Natasha ; Connolly, Jake ; Arrigoni, Francesca ; Garcia Abner, Alejandro ; Kamn'gona, Raphael ; Sheha, Irene ; Chammudzi, Mishek ; Jambo, Kondwani ; Mallewa, Jane ; Rapala, Alicja ; Mallon, Patrick W. G. ; Mwandumba, Henry ; Klein, Nigel ; Khoo, Saye ; Uthman, Olalekan</creatorcontrib><description>Background Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. Methods We recruited Malawian adults with CD4<100 cells/ul two weeks after starting ART in the REALITY trial (NCT01825031), as well as volunteers without HIV infection. Clinical assessment, socioeconomic evaluation, blood draw for immune activation markers and carotid femoral pulse wave velocity (cfPWV) were carried out at 2- and 42-weeks post-ART initiation. Socioeconomic risk factors for immune activation and arterial stiffness were assessed using linear regression models. Results Of 279 PLWH, the median (IQR) age was 36 (31-43) years and 122 (44%) were female. Activated CD8 T-cells increased from 70% amongst those with no education to 88% amongst those with a tertiary education (p = 0.002); and from 71% amongst those earning less than 10 USD/month to 87% amongst those earning between 100-150 USD/month (p = 0.0001). Arterial stiffness was also associated with higher SES (car ownership p = 0.003, television ownership p = 0.012 and electricity access p = 0.029). Conversely, intermediate monocytes were higher amongst those with no education compared to a tertiary education (12.6% versus 7.3%; p = 0.01) and trended towards being higher amongst those earning less than 10 USD/month compared to 100-150 USD/month (10.5% versus 8.0%; p = 0.08). Water kiosk use showed a protective association against T cell activation (p = 0.007), as well as endothelial damage (MIP1 beta, sICAM1 and sVCAM1 p = 0.047, 0.026 and 0.031 respectively). Conclusions Socioeconomic risk factors for persistent inflammation amongst PLWH in SSA differ depending on the type of inflammatory pathway. Understanding these pathways and their socioeconomic drivers will help identify those at risk and target interventions for NCDs. Future studies assessing drivers of inflammation in HIV should include an SES assessment.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0256576</identifier><identifier>PMID: 34432828</identifier><language>eng</language><publisher>SAN FRANCISCO: Public Library Science</publisher><subject>Adult ; Antiretroviral therapy ; Biology and Life Sciences ; Biomarkers - metabolism ; Carotid-Femoral Pulse Wave Velocity ; CD4 antigen ; CD8 antigen ; Cell activation ; Childrens health ; Economic aspects ; Education ; Educational Status ; Family Characteristics ; Female ; Growth factors ; Health aspects ; Health risks ; HIV ; HIV infection ; HIV Infections - epidemiology ; HIV Infections - immunology ; HIV Infections - pathology ; HIV Infections - physiopathology ; HIV patients ; Human immunodeficiency virus ; Humans ; Income ; Inflammation ; Inflammation - epidemiology ; Inflammation - immunology ; Inflammation - pathology ; Inflammation - physiopathology ; Low income groups ; Lymphocytes ; Lymphocytes T ; Malawi - epidemiology ; Male ; Medicine ; Medicine and Health Sciences ; Monocytes ; Mortality ; Multidisciplinary Sciences ; Ownership ; Pathogens ; Plasma ; Proteins ; Regression analysis ; Regression models ; Risk analysis ; Risk factors ; Science & Technology ; Science & Technology - Other Topics ; Social aspects ; Social Class ; Social classes ; Socioeconomic factors ; Socioeconomic status ; Socioeconomics ; Stiffness ; Television ; Tumor necrosis factor-TNF ; Water ; Wave velocity</subject><ispartof>PloS one, 2021-08, Vol.16 (8), p.e0256576-e0256576, Article 0256576</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Kelly et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Kelly et al 2021 Kelly et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>0</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000729171700018</woscitedreferencesoriginalsourcerecordid><cites>FETCH-LOGICAL-c641t-3197e5de79f3e2bf49f694b30513ca318dddc5e41fe644fe903729db1c4c5973</cites><orcidid>0000-0002-3239-7714 ; 0000-0002-6224-0654 ; 0000-0002-3195-2210 ; 0000-0003-3925-9258 ; 0000-0001-8179-4700</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386842/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386842/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,2929,23871,27929,27930,39263,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34432828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Uthman, Olalekan</contributor><creatorcontrib>Kelly, Christine</creatorcontrib><creatorcontrib>Tinago, Willard</creatorcontrib><creatorcontrib>Alber, Dagmar</creatorcontrib><creatorcontrib>Hunter, Patricia</creatorcontrib><creatorcontrib>Luckhurst, Natasha</creatorcontrib><creatorcontrib>Connolly, Jake</creatorcontrib><creatorcontrib>Arrigoni, Francesca</creatorcontrib><creatorcontrib>Garcia Abner, Alejandro</creatorcontrib><creatorcontrib>Kamn'gona, Raphael</creatorcontrib><creatorcontrib>Sheha, Irene</creatorcontrib><creatorcontrib>Chammudzi, Mishek</creatorcontrib><creatorcontrib>Jambo, Kondwani</creatorcontrib><creatorcontrib>Mallewa, Jane</creatorcontrib><creatorcontrib>Rapala, Alicja</creatorcontrib><creatorcontrib>Mallon, Patrick W. G.</creatorcontrib><creatorcontrib>Mwandumba, Henry</creatorcontrib><creatorcontrib>Klein, Nigel</creatorcontrib><creatorcontrib>Khoo, Saye</creatorcontrib><title>Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status</title><title>PloS one</title><addtitle>PLOS ONE</addtitle><addtitle>PLoS One</addtitle><description>Background Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. Methods We recruited Malawian adults with CD4<100 cells/ul two weeks after starting ART in the REALITY trial (NCT01825031), as well as volunteers without HIV infection. Clinical assessment, socioeconomic evaluation, blood draw for immune activation markers and carotid femoral pulse wave velocity (cfPWV) were carried out at 2- and 42-weeks post-ART initiation. Socioeconomic risk factors for immune activation and arterial stiffness were assessed using linear regression models. Results Of 279 PLWH, the median (IQR) age was 36 (31-43) years and 122 (44%) were female. Activated CD8 T-cells increased from 70% amongst those with no education to 88% amongst those with a tertiary education (p = 0.002); and from 71% amongst those earning less than 10 USD/month to 87% amongst those earning between 100-150 USD/month (p = 0.0001). Arterial stiffness was also associated with higher SES (car ownership p = 0.003, television ownership p = 0.012 and electricity access p = 0.029). Conversely, intermediate monocytes were higher amongst those with no education compared to a tertiary education (12.6% versus 7.3%; p = 0.01) and trended towards being higher amongst those earning less than 10 USD/month compared to 100-150 USD/month (10.5% versus 8.0%; p = 0.08). Water kiosk use showed a protective association against T cell activation (p = 0.007), as well as endothelial damage (MIP1 beta, sICAM1 and sVCAM1 p = 0.047, 0.026 and 0.031 respectively). Conclusions Socioeconomic risk factors for persistent inflammation amongst PLWH in SSA differ depending on the type of inflammatory pathway. Understanding these pathways and their socioeconomic drivers will help identify those at risk and target interventions for NCDs. Future studies assessing drivers of inflammation in HIV should include an SES assessment.</description><subject>Adult</subject><subject>Antiretroviral therapy</subject><subject>Biology and Life Sciences</subject><subject>Biomarkers - metabolism</subject><subject>Carotid-Femoral Pulse Wave Velocity</subject><subject>CD4 antigen</subject><subject>CD8 antigen</subject><subject>Cell activation</subject><subject>Childrens health</subject><subject>Economic aspects</subject><subject>Education</subject><subject>Educational Status</subject><subject>Family Characteristics</subject><subject>Female</subject><subject>Growth factors</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - pathology</subject><subject>HIV Infections - physiopathology</subject><subject>HIV patients</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Income</subject><subject>Inflammation</subject><subject>Inflammation - epidemiology</subject><subject>Inflammation - immunology</subject><subject>Inflammation - pathology</subject><subject>Inflammation - physiopathology</subject><subject>Low income groups</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Malawi - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Monocytes</subject><subject>Mortality</subject><subject>Multidisciplinary Sciences</subject><subject>Ownership</subject><subject>Pathogens</subject><subject>Plasma</subject><subject>Proteins</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Science & Technology</subject><subject>Science & Technology - Other Topics</subject><subject>Social aspects</subject><subject>Social Class</subject><subject>Social classes</subject><subject>Socioeconomic factors</subject><subject>Socioeconomic status</subject><subject>Socioeconomics</subject><subject>Stiffness</subject><subject>Television</subject><subject>Tumor necrosis factor-TNF</subject><subject>Water</subject><subject>Wave velocity</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11rFDEUhgdRbK3-A9EBQRTZNZlkvm6EsqhdqBS09DZkMiezKZlknGS67r83406XHelFyUVC8pz35HxF0WuMlpjk-POtHXrD9bKzBpYoSbM0z55Ep7gkySJLEHl6dD6JXjh3i1BKiix7Hp0QSklSJMVp1KyN1Lxtubf9Lu6432z5zsW8taZxPu7Adhpire6UaeKt8pv4Yn0TKxP_4JpvVVwrKaGPuRC2r0fG29hZoSwIa2yrROw894N7GT2TXDt4Ne1n0fW3r9eri8Xl1ff16vxyITKK_YLgMoe0hryUBJJK0lJmJa0ISjERnOCirmuRAsUSMkollIjkSVlXWFCRljk5i97uZTttHZtS5FjIDqU5LWgRiPWeqC2_ZV2vWt7vmOWK_buwfcN475XQwICmpaypkOFrtE4IT_IyhaqQqCpRldKg9WXyNlQt1AKM77meic5fjNqwxt6xItShoEkQ-DAJ9Pb3AM6zVjkBWnMDdtj_u0wRRiSg7_5DH45uohoeAlBG2uBXjKLsPMsJzooCj26XD1Bh1RAqFvpJqnA_M_g4MwiMhz--4YNzbP3r5-PZq5s5-_6I3QDXfuOsHryyxs1BugdFb53rQR6SjBEbx-E-G2wcBzaNQzB7c1ygg9F9_wfg0x7YQmWlEwqMgAOGEArdhXOchxMe6eLx9EqFxg9xrOxgPPkLVe4muw</recordid><startdate>20210825</startdate><enddate>20210825</enddate><creator>Kelly, Christine</creator><creator>Tinago, Willard</creator><creator>Alber, Dagmar</creator><creator>Hunter, Patricia</creator><creator>Luckhurst, Natasha</creator><creator>Connolly, Jake</creator><creator>Arrigoni, Francesca</creator><creator>Garcia Abner, Alejandro</creator><creator>Kamn'gona, Raphael</creator><creator>Sheha, Irene</creator><creator>Chammudzi, Mishek</creator><creator>Jambo, Kondwani</creator><creator>Mallewa, Jane</creator><creator>Rapala, Alicja</creator><creator>Mallon, Patrick W. 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G. ; Mwandumba, Henry ; Klein, Nigel ; Khoo, Saye</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c641t-3197e5de79f3e2bf49f694b30513ca318dddc5e41fe644fe903729db1c4c5973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Antiretroviral therapy</topic><topic>Biology and Life Sciences</topic><topic>Biomarkers - metabolism</topic><topic>Carotid-Femoral Pulse Wave Velocity</topic><topic>CD4 antigen</topic><topic>CD8 antigen</topic><topic>Cell activation</topic><topic>Childrens health</topic><topic>Economic aspects</topic><topic>Education</topic><topic>Educational Status</topic><topic>Family Characteristics</topic><topic>Female</topic><topic>Growth factors</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV infection</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - immunology</topic><topic>HIV Infections - pathology</topic><topic>HIV Infections - physiopathology</topic><topic>HIV patients</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Income</topic><topic>Inflammation</topic><topic>Inflammation - epidemiology</topic><topic>Inflammation - immunology</topic><topic>Inflammation - pathology</topic><topic>Inflammation - physiopathology</topic><topic>Low income groups</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Malawi - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Monocytes</topic><topic>Mortality</topic><topic>Multidisciplinary Sciences</topic><topic>Ownership</topic><topic>Pathogens</topic><topic>Plasma</topic><topic>Proteins</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Science & Technology</topic><topic>Science & Technology - Other Topics</topic><topic>Social aspects</topic><topic>Social Class</topic><topic>Social classes</topic><topic>Socioeconomic factors</topic><topic>Socioeconomic status</topic><topic>Socioeconomics</topic><topic>Stiffness</topic><topic>Television</topic><topic>Tumor necrosis factor-TNF</topic><topic>Water</topic><topic>Wave velocity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kelly, Christine</creatorcontrib><creatorcontrib>Tinago, Willard</creatorcontrib><creatorcontrib>Alber, Dagmar</creatorcontrib><creatorcontrib>Hunter, Patricia</creatorcontrib><creatorcontrib>Luckhurst, Natasha</creatorcontrib><creatorcontrib>Connolly, Jake</creatorcontrib><creatorcontrib>Arrigoni, Francesca</creatorcontrib><creatorcontrib>Garcia Abner, Alejandro</creatorcontrib><creatorcontrib>Kamn'gona, Raphael</creatorcontrib><creatorcontrib>Sheha, Irene</creatorcontrib><creatorcontrib>Chammudzi, Mishek</creatorcontrib><creatorcontrib>Jambo, Kondwani</creatorcontrib><creatorcontrib>Mallewa, Jane</creatorcontrib><creatorcontrib>Rapala, Alicja</creatorcontrib><creatorcontrib>Mallon, Patrick W. G.</creatorcontrib><creatorcontrib>Mwandumba, Henry</creatorcontrib><creatorcontrib>Klein, Nigel</creatorcontrib><creatorcontrib>Khoo, Saye</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kelly, Christine</au><au>Tinago, Willard</au><au>Alber, Dagmar</au><au>Hunter, Patricia</au><au>Luckhurst, Natasha</au><au>Connolly, Jake</au><au>Arrigoni, Francesca</au><au>Garcia Abner, Alejandro</au><au>Kamn'gona, Raphael</au><au>Sheha, Irene</au><au>Chammudzi, Mishek</au><au>Jambo, Kondwani</au><au>Mallewa, Jane</au><au>Rapala, Alicja</au><au>Mallon, Patrick W. G.</au><au>Mwandumba, Henry</au><au>Klein, Nigel</au><au>Khoo, Saye</au><au>Uthman, Olalekan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status</atitle><jtitle>PloS one</jtitle><stitle>PLOS ONE</stitle><addtitle>PLoS One</addtitle><date>2021-08-25</date><risdate>2021</risdate><volume>16</volume><issue>8</issue><spage>e0256576</spage><epage>e0256576</epage><pages>e0256576-e0256576</pages><artnum>0256576</artnum><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background Non-communicable diseases (NCDs) are increased amongst people living with HIV (PLWH) and are driven by persistent immune activation. The role of socioeconomic status (SES) in immune activation amongst PLWH is unknown, especially in low-income sub-Saharan Africa (SSA), where such impacts may be particularly severe. Methods We recruited Malawian adults with CD4<100 cells/ul two weeks after starting ART in the REALITY trial (NCT01825031), as well as volunteers without HIV infection. Clinical assessment, socioeconomic evaluation, blood draw for immune activation markers and carotid femoral pulse wave velocity (cfPWV) were carried out at 2- and 42-weeks post-ART initiation. Socioeconomic risk factors for immune activation and arterial stiffness were assessed using linear regression models. Results Of 279 PLWH, the median (IQR) age was 36 (31-43) years and 122 (44%) were female. Activated CD8 T-cells increased from 70% amongst those with no education to 88% amongst those with a tertiary education (p = 0.002); and from 71% amongst those earning less than 10 USD/month to 87% amongst those earning between 100-150 USD/month (p = 0.0001). Arterial stiffness was also associated with higher SES (car ownership p = 0.003, television ownership p = 0.012 and electricity access p = 0.029). Conversely, intermediate monocytes were higher amongst those with no education compared to a tertiary education (12.6% versus 7.3%; p = 0.01) and trended towards being higher amongst those earning less than 10 USD/month compared to 100-150 USD/month (10.5% versus 8.0%; p = 0.08). Water kiosk use showed a protective association against T cell activation (p = 0.007), as well as endothelial damage (MIP1 beta, sICAM1 and sVCAM1 p = 0.047, 0.026 and 0.031 respectively). Conclusions Socioeconomic risk factors for persistent inflammation amongst PLWH in SSA differ depending on the type of inflammatory pathway. Understanding these pathways and their socioeconomic drivers will help identify those at risk and target interventions for NCDs. Future studies assessing drivers of inflammation in HIV should include an SES assessment.</abstract><cop>SAN FRANCISCO</cop><pub>Public Library Science</pub><pmid>34432828</pmid><doi>10.1371/journal.pone.0256576</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-3239-7714</orcidid><orcidid>https://orcid.org/0000-0002-6224-0654</orcidid><orcidid>https://orcid.org/0000-0002-3195-2210</orcidid><orcidid>https://orcid.org/0000-0003-3925-9258</orcidid><orcidid>https://orcid.org/0000-0001-8179-4700</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-08, Vol.16 (8), p.e0256576-e0256576, Article 0256576 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8386842 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS) Journals Open Access; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Antiretroviral therapy Biology and Life Sciences Biomarkers - metabolism Carotid-Femoral Pulse Wave Velocity CD4 antigen CD8 antigen Cell activation Childrens health Economic aspects Education Educational Status Family Characteristics Female Growth factors Health aspects Health risks HIV HIV infection HIV Infections - epidemiology HIV Infections - immunology HIV Infections - pathology HIV Infections - physiopathology HIV patients Human immunodeficiency virus Humans Income Inflammation Inflammation - epidemiology Inflammation - immunology Inflammation - pathology Inflammation - physiopathology Low income groups Lymphocytes Lymphocytes T Malawi - epidemiology Male Medicine Medicine and Health Sciences Monocytes Mortality Multidisciplinary Sciences Ownership Pathogens Plasma Proteins Regression analysis Regression models Risk analysis Risk factors Science & Technology Science & Technology - Other Topics Social aspects Social Class Social classes Socioeconomic factors Socioeconomic status Socioeconomics Stiffness Television Tumor necrosis factor-TNF Water Wave velocity |
| title | Inflammatory pathways amongst people living with HIV in Malawi differ according to socioeconomic status |
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