title: Association between systemic inflammation and obstructive sleep apnea in men with or at risk for HIV infection.
abstract: BACKGROUND
  We sought to determine whether markers of systemic inflammation are associated with the presence of moderate/severe obstructive sleep apnea (OSA) and whether this association differs based on HIV and HIV treatment status.
  
  
  METHODS
  HIV-uninfected men (HIV-; n=60), HIV-infected men receiving HAART (HIV+/HAART; n=58) and HIV-infected men not receiving HAART (HIV+/no HAART; n=41) underwent polysomnograpy and measurement of plasma levels of tumour necrosis factor (TNF)-α, soluble TNF-α receptors I and II (sTNFRI and sTNFRII) and interleukin (IL)-6. The relationship between moderate/severe OSA (respiratory disturbance index ≥15 apnea/hypopnea events/h) and inflammatory markers was assessed with multivariable regression models.
  
  
  RESULTS
  Compared with the HIV- men, HIV+/HAART men and HIV+/no HAART men had higher levels of TNF-α, sTNFRI and sTNFRII, independent of age, race, smoking status, obstructive lung disease (OLD) and body mass index (BMI). Moderate/severe OSA was present in 48% of the sample (HIV- 57%; HIV+/HAART 41%; HIV+/no HAART 44%). Among the HIV+/no HAART men, but not in the other groups, TNF-α, sTNFRII and IL-6 levels were higher in those with moderate/severe OSA compared to men with no/mild OSA after adjustment for age, race, smoking status, OLD and BMI. Within this group, the association of high TNF-α concentrations with moderate/severe OSA was also independent of CD4(+) T-cell count and plasma HIV RNA concentration.
  
  
  CONCLUSIONS
  Compared with HIV+/HAART men and HIV- men, markers of systemic inflammation were higher in HIV+/no HAART men. In these men, TNF-α was significantly related to OSA, independent of HIV-related covariates.
authors: The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Emily P
authors: EP
authors: Brigham
authors: Susheel P
authors: SP
authors: Patil
authors: Lisa P
authors: LP
authors: Jacobson
authors: Joseph B
authors: JB
authors: Margolick
authors: Rebecca
authors: R
authors: Godfrey
authors: Jacquett
authors: J
authors: Johnson
authors: Lisette M
authors: LM
authors: Johnson-Hill
authors: Sandra
authors: S
authors: Reynolds
authors: Alan R
authors: AR
authors: Schwartz
authors: Philip L
authors: PL
authors: Smith
authors: Todd T
authors: TT
authors: Brown
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000097:blood; D060085:Coinfection; D016207:Cytokines / Q000097:blood; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000453:epidemiology*; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators