Abstract
This study assessed the number of CD4 T lymphocytes, the parasitemia and serum levels of interferon gamma (IFN-gamma), tumor necrosis factor alpha (TNF-alpha), interleukin-1 (IL-1), IL-4 and IL-10 of patients infected by human immunodeficiency virus (HIV) and human immunodeficiency virus/Chagas' disease coinfection. CD4 T lymphocytes were low in the two groups of patients, although significantly lower in patients without Chagas' disease. Serum levels of IFN-gamma, IL-4 and TNF-alpha were significantly higher in patients with HIV/Chagas' disease. IL-4/IFN-gamma ratios were higher in patients with HIV/Chagas' disease, which showed a clear balance in favor of Th2-like cytokines in this group of patients. This Th2 balance was higher in patients with detectable parasitemia. We conclude that, although immunosuppression was observed, with CD4 T lymphocytes below 200/microm3, these patients did not display reactivation of T. cruzi infection and that a balance favorable to Th2 was associated with the presence of parasitemia.
Highlights
This study assessed the number of CD4 T lymphocytes, the parasitemia and serum levels of interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), IL-4 and IL-10 of patients infected by human immunodeficiency virus (HIV) and human immunodeficiency virus/Chagas’ disease coinfection
The number of CD4 T lymphocytes in peripheral blood was significantly higher in patients with HIV/T. cruzi coinfection with a median number of 244 cells, whereas in HIV patients a median of 88 cell/ml was detected (Figure 1a)
When the number of CD4 T lymphocytes was analyzed in patients with Chagas’ disease, according to parasitemia, the number of lymphocytes was higher in patients with T. cruzi parasitemia, this difference was not significant (Figure 1b)
Summary
This study assessed the number of CD4 T lymphocytes, the parasitemia and serum levels of interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-1 (IL-1), IL-4 and IL-10 of patients infected by human immunodeficiency virus (HIV) and human immunodeficiency virus/Chagas’ disease coinfection. IL-4/IFN-γ ratios were higher in patients with HIV/Chagas’ disease, which showed a clear balance in favor of Th2-like cytokines in this group of patients. This Th2 balance was higher in patients with detectable parasitemia. Os níveis séricos de IFN-γ, IL-4 e TNF-α foram significativamente maiores nos pacientes com a co-infecção pelo HIV/Trypanosoma cruzi. In HIV/ leishmaniasis coinfection, it has been proposed that the mechanism of reactivation involves high viral replication and production of Th2 cytokines[17]
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