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Publications

Journal Article Ppublish 2 citations

PubMed: 39453872 DOI: 10.1097/QAD.0000000000004047

Biomarkers of microbial translocation and generalized inflammation are associated with frailty among people with HIV.

AIDS 39(2):153-161

Authors: Stephanie A Ruderman, Peter W Hunt, Gabriele Beck-Engeser, Gabrielle Ambayec, Amanda L Willig, Michael S Saag, Sonia Napravnik, Edward Cachay, Laura Bamford, Alan Landay, Lydia N Drumright, L Sarah Mixson, Bridget M Whitney, Robin M Nance, Mari M Kitahata, Heidi M Crane, Joseph A C Delaney, Andrew W Hahn

Affiliations

  • Department of Medicine, University of Washington, Seattle, WA.
  • Department of Medicine, University of California San Francisco, San Francisco, CA.
  • Department of Infectious Disease, University of Alabama at Birmingham, Birmingham, AL.
  • Division of Infectious Disease, University of North Carolina, Chapel Hill, NC.
  • Department of Medicine, University of California San Diego, San Diego, CA.
  • Department of Internal Medicine, University of Texas Medical Branch Galveston, Galveston, TX, USA.

Abstract

BACKGROUND

Frailty occurs at higher rates and younger ages among people with HIV (PWH) compared with the general population and is often attributed to chronic inflammation and subsequent immune exhaustion. We assessed how inflammatory biomarkers are associated with frailty among PWH.

METHODS

The Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort is comprised of adult PWH in care at 10 sites, and harmonizes demographic, clinical, and patient-reported outcomes (PRO) data. A panel of 13 inflammatory biomarkers was collected from a subset of virally suppressed PWH once per person between 2010 and 2018. Frailty was measured with a validated PRO phenotype, scored 0-4, from biomarker collection date through July 2022. With adjusted linear mixed models, we estimated longitudinal associations between standard deviation-scaled log 2 -transformed biomarkers and frailty score.

RESULTS

Among 273 PWH, most were men (91%), average age at baseline was 45, 42% were non-Hispanic White whereas 35% were non-Hispanic Black, and average follow-up time was 5.5 years. Several biomarkers were associated with higher frailty, including those linked to microbial translocation (sCD14, LBP, KT ratio) and systemic inflammation (CRP, IL-6, suPAR, sTNFR1, sTNFR2). Higher IL-6 was associated with a 0.25-point higher frailty score [95% confidence interval (CI) 0.12-0.39]. Higher sTNFR1 [0.35 (0.13-0.56)], sCD14 [0.21 (0.11-0.31)], and suPAR [0.24 (0.11-0.36)] levels were also associated with higher frailty scores over follow-up.

CONCLUSION

Higher levels of biomarkers linked to microbial translocation and systemic inflammation are associated with higher average frailty scores over time in a cohort of virally suppressed PWH, highlighting these pathways as potential interventional targets for mitigating frailty in PWH.

MeSH

Biomarkers, Acquired Immunodeficiency Syndrome, Hiv, Frailty