631. Markers of Immune Response in Patients with Acute, Chronic and Fatal Infection with Chikungunya Virus in Colombia During the 2015 Epidemic

Abstract

BackgroundAfter 2014 Chikungunya virus (CHIKV) became in public health problem in west world with disability and deterioration in the quality of life that it generates and fatal complications. The objective of this study was. to determine the markers of immune response in patients with acute, chronic and fatal infection by CHIKV in Colombia, during the epidemic in 2015.MethodsCross-sectional study, carried out in serological samples of patients with laboratory-confirmed diagnosed for acute cases (AC), chronic cases (CC) and fatal CHIKV cases (FC). The samples were supplied by the virology laboratory of the National Health Institute and through commercial kit 13 cytokines were processedResultsOne hundred sixty-four samples were analyzed, 50 from patients with AD, 25 from FC due to CHIKV and 89 from patients with CC. The average age was 48.2 years ± 24.4 SD. AC were more prevalent in the extreme ages of life (<10 years and >70 years), and the CC in young adults and intermediate adults (20–60 years) (P < 0.05). The median time taken for the sample was 4.5 [IQR3] days for acute cases and 7 days [IQR1.75] for FC. Ten plasma cytokines (INF-gamma, IL-10, IL-13, IL-17a, IL-2, IL-4, IL-5, IL-6, TGF-α, TNF-α) were significantly elevated in patients deceased compared with patients with acute infection (P < 0.005). In patients with FC, IL-6 was the pro-inflammatory cytokines with the highest median value and among the anti-inflammatory cytokines, IL-10. Exception of GM-CSF and IL-12, the comparison of medians between FC and patients with CC (INF-gamma, IL-10, IL-13, IL-17a, IL-2, IL-4, IL- 5, IL-6, LT-α/TNF-β, TGF-α, TNF-α) presented statistically significant differences (P < 0.05). The levels of IL-6 and IFN-γ were eight and two times higher in patients with AC than in the group with CC.ConclusionThis is the first study conducted in Colombia, which provides evidence on cytokine levels in the acute, fatal and chronic outcome of patients with CHIKV. AC had an increase in IFN-γ, IL-5, IL-6, IL-10, IL-12, IL-17a and TNF-α cytokines, which if persisted elevated for more than 3 months with some decreased levels of IFN-γ and IL-6, maybe progression to chronic phase. If in addition of acute phase cytokines, IL-2, IL-4, IL-13, LT-α/TNF-β, TGF-α increase, the disease maybe severe or fatal. Cytokines, especially IL-6, is becoming a tool for monitoring, evolution and prognosis of CHIKV disease.Disclosures C. Arteta-Acosta, National Health Institute, Universidad del Norte: Collaborator, Research support. J. Acosta-Reyes, National Health Institute, Universidad del Norte: Collaborator, Research support.