High Plasma Level of Interleukin-18 in HIV-Infected... : JAIDS Journal of Acquired Immune Deficiency Syndromes (original) (raw)

Clinical Science

High Plasma Level of Interleukin-18 in HIV-Infected Subjects With Lipodystrophy

Lindegaard, Birgitte MD*†; Hansen, Ann-Brit Eg MD*; Gerstoft, Jan MD, DrSci*; Pedersen, Bente Klarlund MD, DrSci*†

From *Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Denmark, and †the Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Denmark.

Received for publication October 2, 2003; accepted February 11, 2004.

Supported by the Danish Medical Research Council (22-01-0019) and the Danish Medical National Research Foundation (504-14).

A part of the results presented in the present publications have been presented at 5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, July 8–11, 2003, Paris, France, as a poster.

None of the authors have any commercial interest in the present or other studies.

Reprints: Birgitte Lindegaard, The Department of Infectious Diseases, M7641 Rigshospitalet, Blegdamvej 9 DK-2100, Copenhagen Ø, Denmark (e-mail: [email protected]).

Abstract

The level of interleukin-18 (IL-18) is elevated in patients with HIV infection as well as in people with insulin resistance (IR). As HIV-associated lipodystrophy (LD) shares metabolic characteristics with the metabolic syndrome, it was hypothesized that IL-18 would be elevated in patients with LD. Two groups of HIV-infected men with LD, one with fat accumulation (mixed group) (n = 12) and one without fat accumulation (lipoatrophic group) (n = 15) were included. Controls were HIV-positive men without LD (n = 15) and HIV-negative, age-matched men (n = 12). The levels of plasma IL-18 were elevated in all 3 HIV groups compared with HIV-negative controls (P <0.01). In the HIV groups the lipoatrophic group had the highest IL-18, followed by the mixed group and the HIV-positive controls. Only the differences between the lipoatrophic group and the HIV-positive controls were significant (P <0.01). Plasma IL-18 correlated with tumor necrosis factor-α (P <0.05), but not IL-6, adiponectin, or HOMA-IR (homeostasis model of insulin resistance). In contrast to the HIV-negative controls, IL-18 did not correlate with total or low-density cholesterol in either of the HIV groups. An inverse correlation was observed between IL-18 and limb fat (P <0.05). In conclusion, the level of IL-18 is elevated in patients with LD and closely linked to limb atrophy, whereas it is not associated with cholesterol or IR.