Interleukin-1α is associated with IL-17A but not haemoglobin or hypertension in people living with HIV

Persistent immune activation contributes to cardiovascular and haematological complications in people living with HIV despite effective antiretroviral therapy (ART). However, the interplay between interleukin-1 alpha (IL-1α), immunological markers, and haematological parameters in the context of HIV remains incompletely understood. This study investigated the association between IL-1α and immunological and haematological parameters in adults with and without HIV, with a focus on HIV-associated hypertension. A cross-sectional study was conducted among 227 adult participants at Livingstone University Teaching Hospital medical clinic between 01 October 2023 and 01 June 2024. Sociodemographic and clinical data were collected using standardized questionnaires. Multivariable linear regression was performed to identify factors independently associated with IL-1α levels, adjusting for biologically relevant variables and those with p < 0.05 in univariable analysis. The median age of participants was 50 years (IQR: 40, 59), with the majority being female (68.0%, n = 155) and living with HIV (64.3%, n = 146). In multivariable analysis, IL-17 A showed a strong positive association with IL-1α (β = 0.981, 95% CI: 0.855–1.108, p < 0.001). Additionally, female sex (β=-0.394, 95% CI: -0.676 to -0.112, p = 0.004) and being married (β=-0.333, 95% CI: -0.573 to -0.094, p = 0.007) were independently associated with lower IL-1α levels. High-sensitivity C-reactive protein (hs-CRP) was positively associated with IL-1α (β = 0.148, 95% CI: 0.040–0.256, p = 0.008), while high-density lipoprotein (HDL) cholesterol showed a negative association (β=-0.336, 95% CI: -0.637 to -0.034, p = 0.030). In subgroup analysis restricted to PLWH, fasting insulin emerged as an additional independent predictor (β = 0.012, 95% CI: 0.001–0.023, p = 0.026). Haemoglobin, red blood cell count, lymphocyte count, and hypertension status were not independently associated with IL-1α in the final adjusted model. This study demonstrates that IL-1α is independently associated with IL-17 A and hs-CRP but not with haemoglobin levels or hypertension. These findings support the involvement of IL-1α-related inflammatory pathways in immune dysregulation and may have implications for understanding cardiovascular risk in PLWH. The associations with female sex, marital status, and HDL cholesterol highlight the influence of biological, psychosocial, and metabolic factors on inflammatory profiles. Further longitudinal studies are needed to elucidate causal relationships and explore the clinical utility of IL-1α as a biomarker. Not applicable.