Chronic jet lag has been discovered in HIV-positive people, study shows

Scientists suggest that people living with HIV have an internal body clock that is greatly delayed.
Nergis Firtina
Stock image of a scientist in lab.
Stock image of a scientist in lab.

gevende/iStock 

British and South African scientists concluded that people living with HIV have an internal body clock that is greatly delayed, which is consistent with the symptoms of jet lag.

Recently published in the Journal of Pineal Research on October 29, the study might explain some of the health problems experienced by people with HIV and "guide research towards improving their quality of life," as per a press release published by Northumbria University.

HIV in Africa is one of the most severe humanitarian crises. As stated in the SOS, Africans account for two-thirds of all HIV-infected people worldwide.

Researchers from Northumbria and Surrey universities in the United Kingdom, as well as the University of the Witwatersrand and the University of Cape Town in South Africa, evaluated adults aged 45 and above in Mpumalanga province, where one in every four persons has HIV. As a result, the sickness is endemic and unrelated to any lifestyle modifications.

They discovered that in HIV-positive subjects, physiological daily rhythms, as indicated by the melatonin, were delayed by more than an hour on average. Their sleep cycle was also shorter, with researchers seeing that it began later and ended earlier.

Chronic jet lag has been discovered in HIV-positive people, study shows
HIV Test, HIV Positive.

In light of the findings, the study suggests the possibility that HIV infection may cause a circadian rhythm disorder similar to the disruption experienced in shift work or jet lag.

"The participants living with HIV essentially experience the one-hour disruption associated with switching to daylight savings time, but every single morning," says Professor Malcolm von Schantz, Professor of Chronobiology at Northumbria University, corresponding author of the publication.

"This happens in spite of the fact that essentially everybody is exposed to the same light-dark cycle. Our findings have important potential implications for the health and well-being of people living with HIV, especially given the well-established relationships between disrupted circadian rhythms and sleep deprivation."

"Our findings have important potential implications"

"This is very similar to the risk profile observed in shift workers. Understanding and mitigating this disruption may be an important step towards helping people living with HIV live healthier lives," added Dr. Karine Scheuermaier from the University of the Witwatersrand, senior author of the study.

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"Our findings identify an urgent research topic," says Xavier Gómez-Olivé, also from the University of the Witwatersrand, whose research grant funded the study. "The next step must be to establish if the same body clock disruption exists in people living with HIV who are younger and who live in other countries."

"This is a great example of the importance of studying sleep in people living in Africa, and demonstrates how findings from this research can also be relevant to people anywhere in the world," added Co-author Dale Rae from the University of Cape Town.

Abstract:

The increasing number of people living with human immunodeficiency virus, HIV, (PLWH) have an elevated incidence of risk for noncommunicable comorbidities, the aetiology of which remains incompletely understood. While sleep disturbances are often reported in PLWH, it is unknown to what extent they relate to changes in the circadian and/or sleep homeostatic processes. We studied the relationship between sleep characteristics, circadian phase, and HIV status in older adults from the HAALSI (Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community in South Africa) subsample of the Agincourt Health and Demographic Surveillance System in South Africa (n = 187, 36 human immunodeficiency virus positive [HIV+], age: 66.7 ± 11.5 years, range 45—93 years), where HIV prevalence is high and (in contrast to the global north) does not associate significantly with potentially confounding behavioural differences. In participants with valid actigraphy data (n = 172), regression analyses adjusted for age and sex indicated that HIV+ participants had slightly later sleep onset (β = .16, p = .039), earlier sleep offset times (β = −.16, p = .049) and shorter total sleep times (β = −.20, p = .009) compared to the HIV negative (HIV−) participants. In a subset of participants (n = 51, 11 HIV+), we observed a later dim light melatonin onset (DLMO) in HIV+ (21:16 ± 01:47) than in HIV− (20:06 ± 00:58) participants (p = .006). This substantial difference remained when adjusted for age and sex (β = 1.21; p = .006). In 36 participants (6 HIV+) with DLMO and actigraphy data, median phase angle of entrainment was −6 min in the HIV+ group and +1 h 25 min in the HIV− group. DLMO time correlated with sleep offset (ρ = 0.47, p = .005) but not sleep onset (ρ = −0.086, p = .623). Collectively, our data suggest that the sleep phase occurred earlier than what would be biologically optimal among the HIV+ participants. This is the first report of a mistimed circadian phase in PLWH, which has important potential implications for their health and well-being, especially given the well-established relationships between circadian asynchrony and sleep deprivation with poorer health outcomes.

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