Association between HIV replication and serum leptin levels: an observational study of a cohort of HIV-1-infected South African women

Livio Azzoni, Nigel J Crowther, Cynthia Firnhaber, Andrea S Foulkes, Xiangfan Yin, Deborah Glencross, Robert Gross, Mitch D Kaplan, Emmanouil Papasavvas, Doreen Schulze, Wendy Stevens, Tessa van der Merwe, Rita Waisberg, Ian Sanne, Luis J Montaner, Livio Azzoni, Nigel J Crowther, Cynthia Firnhaber, Andrea S Foulkes, Xiangfan Yin, Deborah Glencross, Robert Gross, Mitch D Kaplan, Emmanouil Papasavvas, Doreen Schulze, Wendy Stevens, Tessa van der Merwe, Rita Waisberg, Ian Sanne, Luis J Montaner

Abstract

Background: Advanced HIV infection can result in lipoatrophy and wasting, even in the absence of ongoing opportunistic infections, suggesting that HIV may directly affect adipose tissue amount and distribution.

Methods: We assessed the relationship of fat (measured using anthropometry, DEXA, MRI scans) or markers related to glucose and lipid metabolism with viral load in a cross-sectional sample of 83 antiretroviral-naïve HIV-1-infected South African women. A multivariable linear model was fitted to log10VL to assess the combined effect of these variables.

Results: In addition to higher T cell activation, women with viral load greater than the population median had lower waist circumference, body mass index and subcutaneous abdominal fat, as well as lower serum leptin. We demonstrate that leptin serum levels are inversely associated with viral replication, independent of the amount of adipose tissue. This association is maintained after adjusting for multiple variables associated with disease progression (i.e., cellular activation and innate immunity effector levels).

Conclusions: Our results demonstrate that serum leptin levels are inversely associated with viral replication, independent of disease progression: we postulate that leptin may affect viral replication.

Figures

Figure 1
Figure 1
Association of serum leptin levels with subcutaneous fat. Linear regression modelling of the association between observed serum leptin levels and MRI-assessed subcutaneous fat area. Circles represent individual observations. P < 0.0001; adjusted R2 = 0.5983.
Figure 2
Figure 2
Association of metabolic and immunologic parameters with HIV viral load. Linear regression modelling of the association between log10 serum viral load and significantly associated variables; individual p values and adjusted R2 for the associations are indicated. Circles represent individual observations.

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