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Persistent Low Grade Inflammation is linked to Metabolic Dysfunction in HIV‐positive South African Females

Protease inhibitors (PIs) is linked to adverse metabolic/anthropometric derangements, increasing the risk for cardiovascular diseases (CVD) onset in HIV‐infected individuals. As limited information is available regarding such PI‐mediated effects in the South African context, this cross‐sectional study evaluated an HIV‐positive female population (20‐40 years) in the Cape Winelands Health District. Participants were classed into: a) HIV‐negative, b) HAART‐naïve, and c) PI‐treated groups that underwent basic anthropometrical evaluations (weight, height, body mass index [BMI], hip circumference, waist circumference), and bioelectrical impedance measurements (fat mass, visceral adipose tissue and subcutaneous adipose tissue). An assessment of circulating biomarkers for inflammation (C‐reactive protein [CRP]) and metabolic dysfunction (leptin) was also completed. These data reveal that females from all three groups displayed elevated waist‐to‐hip ratios, with those on PI treatment exhibiting increased vs. matched controls. Moreover, HIV‐positive individuals displayed strong positive correlations between CRP and leptin (r=0.71) and leptin and BMI (r=0.85; p<0.05), and moderate positive correlations between leptin and total fat (r=0.61), CRP and total fat (r=0.49), as well as CRP and BMI (r=0.67). Our data show that persistent low grade inflammation is strongly linked to metabolic dysfunction and obesity in relatively young HIV‐positive South African females. Such changes therefore place female HIV‐positive individuals at increased risk for the future development of CVD that will require an integrated clinical strategy to help counter this growing threat.