Hypertension and immune activation in antiretroviral therapy naïve people living with human immunodeficiency virus

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 630 - 10
• Main Authors: Mwakyandile, Tosi M., Shayo, Grace A., Sasi, Philip G., Mugusi, Ferdinand M., Barabona, Godfrey, Ueno, Takamasa, Lyamuya, Eligius F.
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24.06.2024; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; Aspirin; Biomarkers - blood; Body mass index; Body size; Cardiovascular diseases; Care and treatment; CD14 antigen; CD38 antigen; Complications and side effects; Dosage and administration; Female; Flow cytometry; Glomerular filtration rate; HIV; HIV infection; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; Human immunodeficiency virus; Humans; Hypertension; Hypertension - drug therapy; Hypertension - immunology; Laboratories; Lipopolysaccharide Receptors - blood; Lymphocyte activation; Lymphocytes; Lymphocytes T; Male; Middle Aged; Monocyte activation; Mortality; Pathogenesis; PD-1 protein; Population studies; Prevention; Regression models; Risk factors; Africa; China; Japan; Tanzania; Hypertension; Lymphocyte activation; HIV; Monocyte activation; Antiretroviral therapy
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09548-x

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. 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. A quarter of the 365 were hypertensive (25.3%, 95% CI 20.9-29.8%), and, had higher median (IQR) body mass index (kg/m ) (23.4 (19.6, 28.0) versus 21.9 (19.3, 25.1)) and lower median (IQR) estimated glomerular filtration rate (mL/min/1.73m ) (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. 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.