Association between systemic inflammation and obstructive sleep apnea in men with or at risk for HIV infection.

Abstract

BACKGROUND:

We sought to determine whether markers of systemic inflammation are associated with the presence of moderate/severe obstructive sleep apnea (OSA) and whether this association differs based on HIV and HIV treatment status.

METHODS:

HIV-uninfected men (HIV-; n=60), HIV-infected men receiving HAART (HIV+/HAART; n=58) and HIV-infected men not receiving HAART (HIV+/no HAART; n=41) underwent polysomnograpy and measurement of plasma levels of tumour necrosis factor (TNF)-α, soluble TNF-α receptors I and II (sTNFRI and sTNFRII) and interleukin (IL)-6. The relationship between moderate/severe OSA (respiratory disturbance index ≥15 apnea/hypopnea events/h) and inflammatory markers was assessed with multivariable regression models.

RESULTS:

Compared with the HIV- men, HIV+/HAART men and HIV+/no HAART men had higher levels of TNF-α, sTNFRI and sTNFRII, independent of age, race, smoking status, obstructive lung disease (OLD) and body mass index (BMI). Moderate/severe OSA was present in 48% of the sample (HIV- 57%; HIV+/HAART 41%; HIV+/no HAART 44%). Among the HIV+/no HAART men, but not in the other groups, TNF-α, sTNFRII and IL-6 levels were higher in those with moderate/severe OSA compared to men with no/mild OSA after adjustment for age, race, smoking status, OLD and BMI. Within this group, the association of high TNF-α concentrations with moderate/severe OSA was also independent of CD4(+) T-cell count and plasma HIV RNA concentration.

CONCLUSIONS:

Compared with HIV+/HAART men and HIV- men, markers of systemic inflammation were higher in HIV+/no HAART men. In these men, TNF-α was significantly related to OSA, independent of HIV-related covariates.

• Authors: Emily P Brigham, Susheel P Patil, Lisa P Jacobson, Joseph B Margolick, Rebecca Godfrey, Jacquett Johnson, Lisette M Johnson-Hill, Sandra Reynolds, Alan R Schwartz, Philip L Smith, Todd T Brown
• Journal: Antiviral therapy (Antivir Ther) Vol. 19 Issue 8 Pg. 725-33 ( 2014) ISSN: 2040-2058 [Electronic] England
• PMID: 24518040 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)

Chemical References

• Biomarkers
• Cytokines
• Inflammation Mediators

Topics

• Adult
• Antiretroviral Therapy, Highly Active
• Biomarkers (blood)
• Coinfection
• Cytokines (blood)
• HIV Infections (complications, diagnosis, drug therapy)
• Humans
• Inflammation (blood, complications, epidemiology)
• Inflammation Mediators (blood)
• Male
• Middle Aged
• Polysomnography
• Risk Factors
• Severity of Illness Index
• Sleep Apnea, Obstructive (blood, complications, diagnosis, epidemiology)