Abstract
Despite high risk for serious non-AIDS events (SNAEs) and accelerated age-related increases in inflammatory markers relative to HIV+ men, HIV+ women have been understudied, particularly in terms of stress impacts on immune parameters. The purpose of this study was to examine sex differences in glucocorticoid–immune stress response in mid-life HIV+ individuals, as poor glucocorticoid control of stress-induced inflammation may contribute to health risk in HIV+ women. Male and female participants completed a threat of shock laboratory stressor. Serum cortisol and cytokines [interleukin (IL)-6, IL-8, IL-10, IL-1β, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interferon (IFN)-γ] were assessed at six timepoints prior to and in response to the stressor. Participants included 8 HIV− controls (n = 5 female) and 9 HIV+ (n = 5 female) who were virally suppressed. Repeated measures mixed models revealed a significant sex by HIV status by time interaction for IL-10, IL-1β, TNF-α, and cortisol. IL-10 response, an anti-inflammatory cytokine, was larger in males than females, regardless of HIV status. TNF-α response was blunted in HIV+ individuals compared with HIV−, and specifically in HIV+ women, IL-1β and cortisol response were blunted. Individuals living with HIV may have impaired coordination between the immune system and hypothalamic pituitary adrenal (HPA) axis. HIV+ women in particular exhibited dysregulated IL-1β and cortisol response to acute stress. Future work should focus on relationships among proinflammatory cytokines, stress, and SNAEs in HIV, with attention to sex as a biological variable.
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Acknowledgements
We acknowledge Richard Tustin III, Nancy Tustin and Laura A. Schankel for performing cytokine and cortisol assays.
Funding
This study was funded by The University of Pennsylvania Perelman School of Medicine’s Mental Health AIDS Research Center, National Institute of Mental Health (NIMH) P30 MH097488 and K24 DA030301 (Epperson).
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Liisa Hantsoo, Sara Kornfield, Claudia Iannelli, Jessica Podcasy, David Metzger, Mary D. Sammel and C. Neill Epperson declares no conflict of interests.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients for being included in the study.
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Hantsoo, L., Kornfield, S., Iannelli, C. et al. Glucocorticoid–immune response to acute stress in women and men living with HIV. J Behav Med 42, 1153–1158 (2019). https://doi.org/10.1007/s10865-019-00029-0
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DOI: https://doi.org/10.1007/s10865-019-00029-0