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Very high levels of inflammation marker CRP in young MSM with or without HIV
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22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018
Mark Mascolini
Young men who have sex with men (YMSM) with or without HIV infection had "highly elevated" levels of the inflammation marker C-reactive protein (CRP) in a Chicago-area study [1]. The finding suggested to Northwestern University researchers that "YMSM, whether infected with HIV or not, may be at increased risk of accelerated cardiovascular disease or other long-term consequences."
MSM continue to account for a high proportion of new HIV infections in the United States and countries with similar epidemics. Prior research documented higher levels of systemic inflammation in YMSM than in heterosexual men [2]. Northwestern University investigators conducted this cross-sectional study to learn more about systemic inflammation in YMSM and to determine whether CRP levels differ between men with and without HIV.
The analysis involved men in RADAR, an ongoing cohort study of YMSM in the Chicago area. Participants were 16 to 29 years old and reported sex with another man in the past year or identified as gay, bisexual, or transgender. The investigators matched HIV-positive and negative men 1-to-1 on age, race, and gender. They measured CRP in all men and IL-6 and TNF-alpha in all YMSM with HIV and selected HIV-negative men. IL-6 and TNF-alpha are associated with CRP production in the liver.
The study included 148 men with HIV and 147 without HIV. The groups differed little in average age (24.3 years overall) and proportions of blacks (65.8%) and Hispanics (21.0%). A higher proportion of men with HIV identified themselves as gay (75.7% versus 58.5%) and a lower proportion identified as bisexual (14.2% versus 28.6%) (P = 0.004). Men with HIV had a lower average body mass index (25.1 versus 26.9 kg/m2, P = 0.029).
Overall unadjusted average CRP was high at 6.59 mg/L (range 0.03 to 172.37 mg/L) and nonsignificantly lower in men with versus without HIV (5.82 versus 7.35 mg/L, P = 0.298). CRP above 3.0 mg/L indicates a high risk of cardiovascular disease, and 49.8% of men had a reading above 3.0 mg/L. CRP concentrations did not differ by race/ethnicity, gender identity, or sexual orientation. Because some CRP levels were so high, the researchers retested selected samples on a different platform and got similar results.
Levels of IL-6 were similar in men with and without HIV (0.54 and 0.50 pg/mL, P = 0.383), while TNF-alpha levels were significantly higher in the HIV group (3.19 versus 1.97 pg/mL, P < 0.001). CRP correlated significantly with both TNF-alpha and IL-6 (P < 0.001).
Northwestern investigators are analyzing data on lifestyle, behavioral, and psychosocial factors in an attempt to pinpoint reasons for heightened inflammation in YMSM with and without HIV. Principal investigator Ethan Morgan told NATAP preliminary analyses implicate biologic factors rather than lifestyle or psychosocial variables. He noted, for example, that previous research links variations in the microbiome and sleep quality with more inflammation.
References
1. Morgan E, Taylor HE, Ryan DT, D’Aquila R, Brian Mustanski B. Evidence for elevated inflammation in young gay and bisexual men. AIDS 2018: 22nd International AIDS Conference, Amsterdam, Netherlands, July 23-27, 2018. Abstract TUPEA018.
2. Hatzenbuehler M, McLaughlin K, Slopen N. Sexual orientation disparities in cardiovascular biomarkers among young adults. Am J Prev Med. 2013;44:612-621.
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