Abstract
Introduction:In response to the human immunodeficiency virus (HIV) infection, activated immune cells produce several cytokines that alter the immune response and HIV disease progression. We quantified Th1/Th2/Th17 cytokines in an antiretroviral therapy naïve (ART) cohort to investigate their correlation with traditional markers of HIV disease progression; CD4+ T-lymphocytes and virus load (VL).Methods:We enrolled 247 HIV-infected ART-naïve participants into the study. CD4+ T- and CD8+ T-lymphocytes were enumerated using flow cytometry. VL was quantified using the Cavidi ExaVirTMLoad assay. IL-2, IL-4, IL-6, IL-10, IL-17A, TNF-α, and IFN-γ levels were quantified using the BD Cytometric Bead Array Human Th1/Th2/Th17 cytokine assay. The Kendall’s rank correlation coefficient was used to determine the correlation between log10transformed data for cytokine levels and CD4+ T- and CD8+ T-lymphocytes, CD4/CD8 ratio, and VL.Results:The median CD4+ T- and CD8+ T-lymphocyte counts were 458 cells/µL (IQR:405-556) and 776 cells/µL (IQR:581-1064), respectively. The median CD4/CD8 ratio was 0.6 (IQR: 0.45-0.86). The median VL was log103.3.copies/mL (IQR:2.74-3.93). Low CD4+ T-lymphocyte counts (p=0.010) and CD4/CD8 ratio (p=0.044) were significantly correlated with high VL. There was no significant correlation of cytokine levels with CD4+ T-, CD8+ T-lymphocyte counts and CD4/CD8 ratio. However, high levels of IL-17A (p=0.012) and IL-6 (p=0.034) were significantly correlated with high VL.Conclusion:Our study contributes to the little knowledge available on the role of cytokine profiles in the immune response to subtype C HIV infection.
Highlights
In response to the human immunodeficiency virus (HIV) infection, activated immune cells produce several cytokines that alter the immune response and HIV disease progression
It is well established that whilst there is a depletion of CD4+ Tlymphocytes counts in HIV infection, there is a compensatory increase in CD8+T-lymphocyte leading to a reduced CD4/CD8 ratio which is normally greater than 1 [16]
In a previous study [17] we showed that the CD4/CD8 ratio could be used as a potential tool for diagnosis of HIV infection in infants under the age of 18 months and in adults
Summary
In response to the human immunodeficiency virus (HIV) infection, activated immune cells produce several cytokines that alter the immune response and HIV disease progression. We quantified Th1/Th2/Th17 cytokines in an antiretroviral therapy naïve (ART) cohort to investigate their correlation with traditional markers of HIV disease progression; CD4+ T-lymphocytes and virus load (VL). Cytokines are crucial to cellular communication and may be key elements in turning on and off the immune response [1]. They play a critical role in immune system homeostasis. There is an intense cytokine “storm” during acute HIV infection [2] which might contribute to severe immune activation, rapid CD4+ T-lymphocyte depletion and increase in virus replication leading to high virus load. Other cytokines; Transforming Growth Factor (TGF)-β, IL-10, IL-13, and IL-4 have been shown to have both activating and inhibitory roles on HIV replication [7]
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