Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Associations of gender and serum total cholesterol with CD4+ T cell count and HIV RNA load in antiretroviral-naïve individuals in Addis Ababa

Authors: Melaku Adal, Rawleigh Howe, Desta Kassa, Abraham Aseffa, Beyene Petros

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

Background

Males are more susceptible than females to infections due to the differences in endocrine-immune interactions. Furthermore, it is reported that lowering cell cholesterol impairs viral replication and infection in vitro. However, the production of oxysterols in vivo by oxidation of cholesterol may result in inhibition of HIV replication. Therefore, this study was designed to determine the associations of gender and serum total cholesterol with CD4+ T cell counts and/or WHO clinical stages, and HIV ribonucleic acid (RNA) load in antiretroviral therapy (ART) naive study population with known sero-positive time of stay in Addis Ababa. 

Methods

A cross-sectional study was conducted from February to August 2013 on 594 HIV-1 infected ART-naïve adult study participants in four hospitals Addis Ababa. CD4+ T-cell count, HIV RNA load, hemoglobin and fasting serum total cholesterol were determined. Socio-demographic characteristics, WHO clinical stages, and height and weight were collected from patients’ chart and triangulated by structured questionnaire. Pearson chi-square test, Spearman rank correlation and univariate and multivariate linear/logistic regression analyses were carried out to determine associations.

Results

Mean HIV RNA load was found to be lower in women than in men (p < 0.05). CD4+ T cell count and serum total cholesterol were found to be significantly correlated with HIV RNA load (p < 0.01). Women were at lower risk of having higher HIV RNA load in comparison to men. In addition, having lower concentrations of serum total cholesterol was found to be independent predictor of higher HIV RNA load in comparison to those with higher concentrations of cholesterol in serum (p < 0.05). The multivariate binomial logistic regression also showed that the immune status was better in women than men, and in the presence of higher serum total cholesterol (p < 0.05).

Conclusion

Gender and serum total cholesterol were found to be associated and independent predictors of HIV RNA load, and CD4+ cell count and/or WHO clinical stages. There is a significant lower HIV RNA load and better CD4+ T cell count in women and those study participants with higher serum total cholesterol.
Appendix
Available only for authorised users
Literature
1.
UNAIDS. AIDS Epidemic Update. Geneva; 2014.
2.
Ethiopia Demographic and Health Survey (EDHS). Addis Ababa; 2011
3.
HIV/AIDS Prevention and Control Office (HAPCO). Country progress report on the HIV response. Addis Ababa; 2014.
4.
Abebe A, Pollakis G, Fontanet AL, Fisseha B, Tegbaru B, Kliphuis A, et al. Identification of a genetic sub-cluster of the HIV-1 subtype C (C’) widespread in Ethiopia. AIDS Res Hum Retrovir. 2000;16:1909–14.CrossRefPubMed
5.
Kassu A, Fujino M, Matsuda M, Nishizawa M, Ota F, Sugiura W. Molecular epidemiology of HIV type 1 in treatment-naïve patients in North Ethiopia. AIDS Res Hum Retrovir. 2007;23:564–8.CrossRefPubMed
6.
WHO. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva; 2015.
7.
8.
9.
Negredo E, Puigdomenech I, Marfil S, Puig J, Perez-Alvarez N, Ruiz L, et al. Association between HIV replication and cholesterol in peripheral blood mononuclear cells in HIV-infected patients interrupting HAART. J Antimicrob Chemother. 2008;61:400–4.CrossRefPubMed
10.
Musiol A, Gran S, Ehrhardt C, Ludwig S, Grewal T, Gerke V, et al. Annexin A6-balanced late endosomal cholesterol controls influenza a replication and propagation. MBio. 2013;4:e00608–13.CrossRefPubMedPubMedCentral
11.
Klein SL. The effects of hormones on gender differences in infection: from genes to behavior. Neurosci Biobehav Rev. 2000;24:627–38.CrossRefPubMed
12.
Hel Z, Stringer E, Mestecky J. Sex steroid hormones, hormonal contraception, and the Immunobiology of human immunodeficiency Virus-1 infection. Endocr Rev. 2010;31:79–97.CrossRefPubMed
13.
Beagley KW, Gockel CM. Regulation of innate and adaptive immunity by the female sex hormones oestradiol and progesterone. FEMS Immunol Med Microbiol. 2003;38:13–22.CrossRefPubMed
14.
Brügger B, Krautkramer E, Tibroni N, Munte CE, Rauch S, Leibrecht I, et al. Human immunodeficiency virus type 1 Nef protein modulates the lipid composition of virions and host cell membrane microdomains. Retrovirology. 2007;4:70–81.CrossRefPubMedPubMedCentral
15.
Morrow MP, Grant A, Mujawar Z, Dubrovsky L, Pushkarsky T, Kiselyeva Y, et al. Stimulation of the liver X receptor pathway inhibits HIV-1 replication via induction of ATP-binding cassette transporter A1. Mol Pharmacol. 2010;78:215–25.CrossRefPubMedPubMedCentral
16.
17.
van’t Wout AB, Swain JV, Schindler M, Rao U, Pathmajeyan MS, Mullins JI, et al. Nef induces multiple genes involved in cholesterol synthesis and uptake in human immunodeficiency virus type 1-infected T cells. J Virol. 2005;79:10053–8.CrossRef
18.
Mujawar Z, Rose H, Morrow MP, Pushkarsky T, Dubrovsky L, Mukhamedova N, et al. Human immunodeficiency virus impairs reverse cholesterol transport from macrophages. PLoS Biol. 2006;4:e365.CrossRefPubMedPubMedCentral
19.
Arora VK, Fredericksen BL, Garcia JV. Nef: agent of cell subversion. Microbes Infect. 2002;4:189–99.CrossRefPubMed
20.
21.
Petersen J, Drake MJ, Bruce EA, Riblett AM, Didigu CA, Wilen CB, et al. The major cellular sterol regulatory pathway is required for Andes virus infection. PLoS Pathog. 2014;10:e1003911.CrossRefPubMedPubMedCentral
22.
Blanc M, Hsieh WY, Robertson KA, Watterson S, Shui G, Lacaze P, et al. Host defense against viral infection involves interferon mediated down-regulation of sterol biosynthesis. PLoS Biol. 2011;9:e1000598.CrossRefPubMedPubMedCentral
23.
Holmes R, VandeBerg J, Cox L. Genomics and proteomics of vertebrate cholesterol ester lipase (LIPA) and cholesterol 25-hydroxylase (CH25H). Biotech. 2011;1:99–109.
24.
Liu S, Aliyari R, Chikere K, Li G, Marsden MD, Smith JK, et al. Interferon-inducible Cholesterol-25-hydroxylase broadly inhibits viral entry by production of 25-hydroxycholesterol. Immunity. 2013;38:92–105.CrossRefPubMed
25.
Cyster JG, Dang EV, Reboldi A, Yi T. 25-hydroxycholesterols in innate and adaptive immunity. Nat Rev Immunol. 2014;14:731–43.CrossRefPubMed
26.
27.
Sterling TR, Vlahov D, Astemborski J, Hoover DR, Margolick JB, Quinn TC. Initial plasma HIV-1 RNA levels and progression to AIDS in women and men. N Engl J Med. 2001;344:720–5.CrossRefPubMed
28.
Gandhi M, Bacchetti P, Miotti P, Quinn TC, Veronese F, Greenblatt RM. Does patient sex affect human immunodeficiency virus levels? Clin Infect Dis. 2002;35:313–22.CrossRefPubMed
29.
Zhang M, Huang Q, Huang Y, Wood O, Yuan W, Chancey C, et al. Beta-estradiol attenuates the anti-HIV-1 efficacy of Stavudine (D4T) in primary PBL. Retrovirology. 2008;5:82–9.CrossRefPubMedPubMedCentral
30.
Rodriguez-Garcia M, Biswas N, Patel MV, Barr FD, Crist SG, Ochsenbauer C, et al. Estradiol reduces susceptibility of CD4+ T cells and macrophages to HIV infection. PLoS One. 2013;8:e62069.CrossRefPubMedPubMedCentral
31.
WHO. Indicators and strategies for Iron deficiency and anaemia programmes, report of a WHO/UNICEF/UNU Consultation. Geneva; 1994. p. 33–47.
32.
Panel, National Cholesterol Education Program NCEP Expert. Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;106:3143.CrossRef
33.
34.
Miguez MJ, Lewis JE, Bryant VE, Rosenberg R, Burbano X, Fishman J, et al. Low cholesterol? Don’t brag yet ... Hypocholesterolemia blunts HAART effectiveness: a longitudinal study. J Int AIDS Soc. 2010;13:25–34.CrossRefPubMedPubMedCentral
35.
Brambilla F, Speca A, Pacchiarotti I, Biondi M. Hormonal background of physiological aggressiveness in psychologically healthy women. Int J Psychophysiol. 2010;75:291–4.CrossRefPubMed
36.
37.
Liu C, Yang XV, Wu J, Kuei C, Mani NS, Zhang L, et al. Oxysterols direct B-cell migration through EBI2. Nature. 2011;475:519–23.CrossRefPubMed
38.
Muldoon MF, Marsland A, Flory JD, Rabin BS, Whiteside TL, Manuck SB. Immune system differences in men with hypo- or hypercholesterolemia. Clin Immunol Immunopathol. 1997;84:145–9.CrossRefPubMed
39.
Ruel TD, Zanoni BC, Sewanyana I, Cao H, Havlir DV, Kamya M, et al. Sex differences in HIV RNA level and CD4 cell percentage during childhood. CID. 2011;53:592–9.CrossRef
40.
Ellegren H, Parsch J. The evolution of sex-biased genes and sex-biased gene expression. Nat Rev Genet. 2007;8:689–98.CrossRefPubMed
41.
42.
Brown M, Kizza M, Watera C, Quigley MA, Rowland S, Hughes P, et al. Helminth infection is not associated with faster progression of HIV disease in coinfected adults in Uganda. J Infec Dis. 2004;190:1869–79.CrossRef
43.
HAPCO. Guidelines for anti retroviral treatment in adults and adolescents. Addis ababa; 2007.
44.
Collini P, Schwab U, Sarfo S, Obeng-Baah J, Norman B, Chadwick D, et al. Sustained immunological responses to highly active antiretroviral therapy at 36 months in a Ghanaian HIV cohort. Clin Infect Dis. 2009;48:988–91.CrossRefPubMed
45.
Kandi V, Bashir A. Advantages of alternate biomarkers in the Management of Human Immunodeficiency Virus with highly active antiretroviral therapy. Trans Biomed. 2016;7:e41.
Metadata
Title
Associations of gender and serum total cholesterol with CD4+ T cell count and HIV RNA load in antiretroviral-naïve individuals in Addis Ababa
Authors
Melaku Adal
Rawleigh Howe
Desta Kassa
Abraham Aseffa
Beyene Petros
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5852-4

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue

Research article

Prevalence of excess body weight and underweight among 26 Chinese ethnic minority children and adolescents in 2014: a cross-sectional observational study

Research article

Examining the relationship between sports participation and youth developmental outcomes for socially vulnerable youth

Research article

Socioeconomic, demographic and lifestyle-related factors associated with unhealthy diet: a cross-sectional study of university students

Research article

The role of severity perceptions and beliefs in natural infections in Shanghai parents’ vaccine decision-making: a qualitative study

Research article

Validating Fitbit Zip for monitoring physical activity of children in school: a cross-sectional study

Research article

Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children