Title:Association between Antiretroviral Treatment and Markers of Systemic Inflammation among HIV Patients in Ghana
Volume: 18
Issue: 6
Author(s): Zelalem T. Haile*, Bismark Sarfo, Evelyn Y. Bonney, Eric A. Mensah and Selase Deletsu
Affiliation:
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin OH-43016,United States
Keywords:
Human Immunodeficiency virus, antiretroviral therapy, systemic inflammation, chronic diseases, CRP, GAM.
Abstract: Background: Studies from high-income countries have reported that even after receiving
antiretroviral treatment (ART), HIV-infected adults may not achieve normal levels of certain inflammatory
markers that are known to be associated with the onset and development of non-communicable
diseases.
Objective: The aim of this study is to examine the relationship between ART and markers of systemic
inflammation in HIV/AIDS patients at an urban antiretroviral clinic in Ghana.
Methods: We examined serum levels of high sensitivity CRP (hsCRP), interleukin-6 (IL-6), interleukin-
18(IL-18), and tumor necrosis factor-α (sTNFR1 and sTNFR2) from 40 HIV infected patients.
Kruskal-Wallis Test was used to examine the differences in markers of systemic inflammation
according to the types of ART medication taken. We then utilized generalized additive models
(GAM) with non-linear function to examine the association between ART and markers of systemic
inflammation after adjusting for potential confounders.
Results: Overall, 30 (75.0%) of the participants received ART and 35 (85%) were female. Kruskal-
Wallis Test revealed no significant differences in the markers of systemic inflammation among the
three categories of ART (none, AZT, 3TC, EFV/NVP, and TDF, 3TC/FTC, EFV/NVP). In the multivariable-
adjusted GAM model, we found a significant but non-linear association between time
since diagnosis and CRP levels (p=0.006).
Conclusion: Although the relatively small sample size limits the scope of the study's findings, these
results suggest that individuals on ART need to be screened periodically for the development
of chronic conditions. This line of investigation has the potential to influence treatment and clinical
guidelines that will improve the quality of care for HIV-infected patients.
