Soluble receptors for tumor necrosis factor are markers for clinical course but not for major metabolic changes in human immunodeficiency virus infection

Tumor necrosis factor alpha (TNF) is a potential mediator of the metabolic changes in human immunodeficiency virus type 1 (HIV) infection. Soluble TNF receptor types I and II (sTNFR-I and -II) presumably reflect TNF activity. To examine the relationship between sTNFRs and host metabolism, resting energy expenditure (REE), body composition, and transferrin, albumin, triglyceride, retinol-binding protein, and sTNFR concentrations were measured in 12 asymptomatic and 18 symptomatic HIV-infected male subjects and 15 male control subjects. sTNFRs were increased in parallel with disease severity. REE was elevated approximately 8% in HIV-infected subjects (P =.005). REE correlated positively with fat free mass (FFM) and the presence of HIV infection, but not with sTNFRs. Inverse correlations existed between sTNFR-I or -II and albumin concentration (r = -.48, P =.007, and r = -.49, P =.006, respectively), between sTNFR-II and transferrin concentration (r = =.53, P =.003), and between In(sTNFR-II) and percent body fat (r = -.37, P <.05), but not between sTNFRs and triglyceride or retinol binding protein. Thus, sTNFRs are markers for clinical course but not for major metabolic changes in HIV infection. Copyright (C) 1995 by W.B. Saunders Company