title: Body burden of heavy metals among HIV high risk population in USA.
abstract: OBJECTIVE
  HIV high risk population may face not only the threat of HIV infection but also a higher chance of exposure to environmental contaminants. However, no previous studies have examined the body burden of environmental pollutants including heavy metals among HIV high risk populations. The aim of this study was to investigate whether adults aged 20-59 years old at high risk of HIV infection have higher blood levels of heavy metals compared to those with low risk of HIV infection in United States.
  
  
  METHODS
  We used the National Health and Nutrition Examination Survey (NHANES) 1999-2010 to compare exposures to heavy metals including cadmium, lead, and total mercury by HIV risk status.
  
  
  RESULTS
  The results showed that people at high risk of HIV had higher blood concentrations of all heavy metals compared to their counterparts with lower HIV risks. In multivariate linear regression models, HIV risk status was significantly associated with increased blood cadmium, lead, and total mercury after adjusting for age, sex, race, education, and poverty income ratio.
  
  
  CONCLUSIONS
  Our study suggests that people at high risk of HIV have significantly higher body burden of heavy metals including cadmium, lead, and mercury compared to those with low risk of HIV. Further longitudinal study collecting more pollutants are warranted to determine the potential health effects of these elevated pollutants on both HIV-infected and HIV high-risk populations.
authors.affiliation: Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M Health Science Center, College Station, TX, United States. Electronic address: xiaohui.xu@sph.tamhsc.edu.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States.
authors.forename: Hui
authors.initials: H
authors.lastname: Hu
authors.affiliation: Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, United States.
authors.forename: Yan Alicia
authors.initials: YA
authors.lastname: Hong
mesh_terms: D000328:Adult; D001822:Body Burden; D004785:Environmental Pollutants / Q000097:blood* / Q000737:chemistry; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D019216:Metals, Heavy / Q000097:blood* / Q000737:chemistry; D008875:Middle Aged; D009749:Nutrition Surveys; D011203:Poverty; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004785:Environmental Pollutants; D019216:Metals, Heavy
keywords: Blood cadmium; Blood lead; Blood mercury; Environmental exposure; HIV high risk population; NHANES