title: Cytokine polymorphisms are associated with fatigue in adults living with HIV/AIDS.
abstract: Fatigue has been associated with inflammation and cytokine activity among adults, but this relationship has not been evaluated among adults living with HIV. Diurnal patterns of fatigue have been previously identified in adults with HIV/AIDS. Thus, the purpose of this study was to describe these fatigue patterns in relation to cytokine plasma concentrations and gene polymorphisms. A convenience sample of 317 adults living with HIV/AIDS completed a measure of fatigue in the morning and evening for three consecutive days; participants reporting low levels of both morning and evening fatigue (n=110) or high levels of fatigue in the morning and evening (n=114) were included in the analysis, resulting in a final sample of 224 adults (151 men, 55 women, and 18 transgender). Plasma cytokines were analyzed, and genotyping was conducted for 15 candidate genes involved in cytokine signaling: interferon-gamma (IFNG), IFNG receptor 1 (IFNGR1), interleukins (IL), nuclear factor of kappa light polypeptide gene enhancer in B cells (NFKB-1 and -2), and tumor necrosis factor alpha (TNFA). Demographic and clinical variables were evaluated as potential covariates. Controlling for genomic estimates of ancestry and self-reported race/ethnicity and gender, the high fatigue pattern was associated with five single nucleotide polymorphisms (SNPs): IL1B rs1071676 and rs1143627, IL4 rs2243274, and TNFA rs1800683 and rs1041981. The IL1B and TNFA polymorphisms were not associated with plasma levels of IL-1β or TNFα, respectively. This study strengthens the evidence for an association between inflammation and fatigue. In this chronic illness population, the cytokine polymorphisms associated with high levels of morning and evening fatigue provide direction for future personalized medicine intervention research.
authors.affiliation: Department of Family Health Care Nursing, University of California, San Francisco, CA, USA. Electronic address: Kathryn.lee@nursing.ucsf.edu.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Lee
authors.affiliation: Department of Family Health Care Nursing, University of California, San Francisco, CA, USA; Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Lovisenberg Diakonale University of College, Oslo, Norway.
authors.forename: Caryl L
authors.initials: CL
authors.lastname: Gay
authors.affiliation: Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
authors.forename: Anners
authors.initials: A
authors.lastname: Lerdal
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, CA, USA; Cardiovascular Research Institute, University of California, San Francisco, CA, USA.
authors.forename: Clive R
authors.initials: CR
authors.lastname: Pullinger
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, CA, USA; Institute for Human Genetics, University of California, San Francisco, CA, USA.
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D016207:Cytokines / Q000097:blood / Q000235:genetics*; D005221:Fatigue / Q000150:complications / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: Biomarker; Cytokine; Fatigue; Genetic; HIV; Inflammation