Can Women Safely Distribute HIV Oral Self-Test Kits to Their Sexual Partners? Results from a Pilot Study in Kenya

Fri, 20 Apr 2018 00:00:00 GMT-05:00 - Agot, Kawango; Masters, Samuel H.; Wango, Gift-Noelle; Thirumurthy, Harsha

Systemic Inflammation, Immune Activation and Impaired Lung Function among People Living with HIV in Rural Uganda

Fri, 20 Apr 2018 00:00:00 GMT-05:00 - North, Crystal M.; Muyanja, Daniel; Kakuhikire, Bernard; Tsai, Alexander C.; Tracy, Russell P.; Hunt, Peter W.; Kwon, Douglas S.; Christiani, David C.; Okello, Samson; Siedner, Mark J.
Εισαγωγή: Although both chronic lung disease and HIV are inflammatory diseases common in sub-Saharan Africa, the relationship between systemic inflammation and lung function among people living with HIV (PLWH) in sub-Saharan Africa is not well described.
Μέθοδοι: We measured lung function (using spirometry) and serum high sensitivity C-reactive protein, IL-6, sCD14 and sCD163 in 125 PLWH on stable antiretroviral therapy and 109 age and sex-similar HIV-uninfected controls in rural Uganda. We modeled the relationship between lung function and systemic inflammation using linear regression, stratified by HIV serostatus, controlled for age, sex, height, tobacco and biomass exposure.
Αποτελέσματα: Half of subjects (46%, [107/234]) were women and the median age was 52 years (IQR 48-55). Most PLWH (92%, [115/125]) were virologically suppressed on first-line antiretroviral therapy. Median CD4 count was 472 cells/mm3. In multivariable linear regression models stratified by HIV serostatus, an interquartile range increase in IL-6 and sCD163 were each inversely associated with lung function (mL, 95% confidence interval) among PLWH (IL-6: FEV1 -18.1 (-29.1, -7.1), FVC -17.1 (-28.2, -5.9); sCD163: FVC -14.3 (-26.9, -1.7)). hsCRP (>3mg/L vs. <1mg/L) was inversely associated with lung function among both PLWH and HIV-uninfected controls (PLWH: FEV1 -39.3 (-61.7, -16.9), FVC -44.0 (-48.4, -6.4); HIV-uninfected: FEV1 -37.9 (-63.2, -12.6), FVC -58.0 (-88.4, -27.5)). sCD14 was not associated with lung function, and all interaction terms were insignificant.
Συμπεράσματα: Macrophage activation and systemic inflammation are associated with lower lung function among PLWH on stable antiretroviral therapy in rural Uganda. Future work should focus on underlying mechanisms and public health implications. Corresponding Author: Crystal M. North, MD Division of Pulmonary and Critical Care Medicine Massachusetts General Hospital 55 Fruit Street, BUL-148 Boston, MA 02114 Phone: 617-726-8854 Fax: 617-724-6878 cnorth@mgh.harvard.edu The authors report no conflicts of interest related to this work. Presentation of Data: Presented at the 2018 Conference on Retroviruses and Opportunistic Infections; March 2018; Boston, MA Sources of Support: This study was funded by the U.S. National Institutes of Health R21 HL124712, P30 AI060354, R24 AG044325, MGH Executive Committee on Research, and Friends of a Healthy Uganda. The authors acknowledge the following additional sources of support: K23 MH096620; K23 MH099916; T32 HL116275; K43 TW010715. Travel support for study investigators was provided by the travel award programs of Massachusetts General Hospital Global Health and the Partners Center of Expertise in Global and Humanitarian Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard University and its affiliated academic healthcare centers or the National Institutes of Health. Author Contributions: CMN conceived of the study design, conducted the data analysis and wrote the first draft of the manuscript. DCC and MJS provided methodological guidance. SO, MJS, BK and ACT led study procedures and data collection. RT and DSK led biomarker-related testing. All authors reviewed and critiqued the final manuscript. - Β© 2018