Lack of association between loneliness, social isolation and inflammation in people living with HIV aged ≥50 years: Results from the sub-study “No One Alone-Gesida Study”

Abstract

Introduction Inflammation is linked to multiple health conditions. Emerging evidence suggest it may play a role in the association between social isolation – loneliness and health outcomes. People living with HIV (PLWH) exhibit chronic inflammation even with viral suppression, likely due to ongoing immune activation. However, few studies have explored inflammatory biomarker in PLWH experiencing loneliness or social isolation. This study aimed to assess this association in PLWH aged 50 or older. Materials and methods This observational, multicenter, cross-sectional study was conducted by the AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology across 22 Spanish hospitals. Participants were classified based on whether they experienced loneliness (UCLA 3-item scale ≥6) and/or social isolation (Lubben Social Network Scale-6 ≤ 20). Blood samples were stored at −80°C, and cytokine levels were measured using the Olink Target 48 Cytokine panel. Multivariable median regression was used to assess differences in inflammatory biomarkers between those experiencing loneliness and/or social isolation and those experiencing neither. Results Among 199 PLWH, 33.2% reported loneliness/social isolation. Those without loneliness/social isolation were more likely to be male (p = 0.023), employed or students (p < 0.001) and had fewer prior AIDS events (p = 0.045) and comorbidities. CSF1 levels were elevated in unadjusted analysis (median difference 11.33; 95% CI 3.50–19.15; p = 0.005) but not in adjusted models. Conclusion No significant increase in inflammatory markers was found in PLWH experiencing loneliness and/or social isolation. Further research should prioritize longitudinal, multi–time-point designs with expanded biomarker panels and test whether connection-enhancing interventions modulate inflammation.