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Background Systemic inflammation independently predicts future cardiovascular events and is associated with a 2-fold increase in cardiovascular disease (CVD) risk among persons living with human immunodeficiency virus (PLHIV). We examined the association between inflammatory markers, HIV status, and traditional CVD risk factors. Methods We conducted a cross-sectional study of Kenyan adults with and without HIV seeking care at Kisumu County Hospital. Using a multiplex immunoassay, we measured interleukin (IL) 1β, IL-6, tumor necrosis factor α (TNF-α), and high-sensitivity C-reactive protein (hsCRP) concentrations. We compared inflammatory marker concentrations by HIV status using the Wilcoxon rank-sum test. Multivariable linear regression was used to evaluate associations between inflammatory biomarkers and HIV status, adjusting for CVD risk factors. Results We enrolled 286 PLHIV and 277 HIV-negative participants. Median duration of antiretroviral therapy for PLHIV was 8 years (interquartile range, 4–10) and 96% were virally suppressed. PLHIV had a 51% higher mean IL-6 concentration (P <.001), 39% higher mean IL-1β (P =.005), 40% higher mean TNF-α (P <.001), and 27% higher mean hsCRP (P =.008) compared with HIV-negative participants, independent of CVD risk factors. Male sex, older age, and obesity were associated with higher concentrations of inflammatory markers. Restricting to PLHIV, viral load of ≥1000 copies/mL was associated with higher TNF-α levels (P =.013). Conclusions We found higher levels of systemic inflammatory biomarkers among PLHIV who were virally suppressed, and this was independent of traditional CVD risk factors. Further longitudinal analyses to determine whether these inflammatory markers predict future CVD events, and are possible therapeutic targets among PLHIV, are warranted. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in pregnancy contribute to adverse perinatal outcomes. Identifying predictors of CT/NG could help optimize diagnostic testing for pregnant women in settings where syndromic management persists as standardof- care. Methods: We analyzed baseline data from a longitudinal study of maternal HIV acquisition. Pregnant women without HIV were enrolled at two antenatal clinics in western Kenya. CT and NG were assessed by nucleic acid amplification tests (NAAT) using endocervical samples. Logistic regression models were used to evaluate potential predictors of CT and/or NG infection. A classification and regression tree (CART) was generated to predict the joint effects of predictors. We determined diagnostic performance of syndromic algorithms using NAATbased diagnosis as the gold standard. Results: Overall, 1276 women had complete CT/NG assessment. Women enrolled at a median of 26 weeks gestation (IQR 22-31), median age was 22 years (IQR 19-27), and xx (78%) were married. In total, 98 (7.7%) tested positive for CT and/or NG: 70 (5.5%) for CT, 32 (2.5%) for NG, and 4 (0.3%) had both. Two-thirds (66%) of CT and/or NG cases were asymptomatic and would have been missed without NAAT diagnosis. Predictors of CT and/or NG included age 0.001.) Compared to the NAAT-based diagnosis, syndromic algorithms demonstrated low sensitivity (34% [95% CI 31-36%]), moderate specificity (76% [95% CI 74-78%]), low positive predictive value (10% [95% CI 9-12%]), and high negative predictive value (93% [95% CI 92%-95%]) for detecting CT and/or NG. Conclusion: In this cohort of pregnant Kenyan women, CT/NG was frequently asymptomatic and common among young unmarried women in newer relationships. Syndromic management alone would have led to underdiagnosis and missed treatment opportunities. Our results suggest antenatal CT/NG testing would be beneficial for young women in new relationships. [ABSTRACT FROM AUTHOR]