Associations of inflammation-related proteome with demographic and clinical characteristics of people with HIV in South Africa

Elevated levels of inflammation associated with HIV infection are considered one of the primary causes for the excess burden of age-related morbidity and mortality among people with HIV (PWH). Circulating protein levels can be used to investigate biological pathways contributing to persistent inflammation among PWH. In this study, we profiled 73 inflammation-related protein markers and assessed their associations with chronological age, sex and CD4+ cell count among 87 black South African PWH prior to initiating ART. We identified 1, 1 and 14 inflammatory proteins significantly associated with sex, CD4+ T-cell count, and age respectively among PWH. Twelve out of 14 age-associated proteins have been reported to be associated with age in the general population, and 4 have previously shown significant associations with age for PWH. Furthermore, many of the age-associated proteins such as CST5, CCL23, SLAMF1, MMP-1, MCP-1, and CDCP1 have been linked to chronic diseases such as cardiovascular disease and neurocognitive decline in the general population. We also found a synergistic interaction between male sex and older age accounting for excessive expression of CST5. In conclusion, we found that age may lead to the elevation of multiple inflammatory proteins among PWH. We also demonstrated the potential utility of proteomics for evaluating and characterizing the inflammatory status among PWH.