Food Insecurity Is Associated With Inflammation Among Women Living With HIV

• Published in: The Journal of infectious diseases Vol. 219; no. 3; pp. 429 - 436
• Main Authors: Leddy, Anna M., Roque, Annelys, Sheira, Lila A., Frongillo, Edward A., Landay, Alan L., Adedimeji, Adebola A., Wilson, Tracey E., Merenstein, Daniel, Wentz, Eryka, Adimora, Adaora A., Ofotokun, Igho, Metsch, Lisa R., Cohen, Mardge H., Tien, Phyllis C., Turan, Janet M., Turan, Bulent, Weiser, Sheri D.
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 09.01.2019
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral drugs; Antiretroviral therapy; Body Mass Index; CD4 antigen; Cross-Sectional Studies; Female; Food; Food security; Food Supply - statistics & numerical data; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - immunology; HIV/AIDS; Human immunodeficiency virus; Humans; Inflammation; Inflammation - epidemiology; Inflammation - immunology; Interleukin 6; Interleukin-6 - immunology; Linear Models; Major and Brief Reports; Middle Aged; Multivariate Analysis; Receptors, Tumor Necrosis Factor, Type I - immunology; Tumor necrosis factor receptors; United States - epidemiology; Womens health; United States; women living with HIV; inflammatory cytokines; HIV; food insecurity; chronic inflammation
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiy511

Abstract Background Chronic inflammation is associated with AIDS-defining and non-AIDS–defining conditions. Limited research has considered how food insecurity influences chronic inflammation among people living with human immunodeficiency virus (HIV). We examined whether food insecurity was associated with higher levels of inflammation among women living with HIV (WWH) in the United States. Methods We analyzed cross-sectional data collected in 2015 from 421 participants on antiretroviral therapy from the Women’s Interagency HIV Study. The exposure was any food insecurity. The outcome was inflammation, measured by proinflammatory cytokine interleukin-6 (IL-6) and tumor necroses factor receptor 1 (TNFR1) levels. We conducted multivariable linear regressions, adjusting for sociodemographic, clinical, and nutritional factors. Results Nearly one-third of participants (31%) were food insecure and 79% were virally suppressed (<20 copies/mL). In adjusted analyses, food insecurity was associated with 1.23 times the level of IL-6 (95% confidence interval [CI], 1.06–1.44) and 1.13 times the level of TNFR1 (95% CI, 1.05–1.21). Findings did not differ by HIV control (virally suppressed with CD4 counts ≥500 cells/mm3 or not) in adjusted stratified analyses. Conclusion Food insecurity was associated with elevated inflammation among WWH regardless of HIV control. Findings support the need for programs that address food insecurity among WWH. Among a sample of women living with HIV in the United States, food insecurity was associated with elevated levels of proinflammatory cytokines interleukin-6 and tumor necrosis factor receptor 1, regardless of HIV control.