Cytokine’s Imbalance, the Hallmark of Immune Dysfunction in HIV/AIDS Patients in Rwanda

Abstract

Background: Cytokines network drive Human Immunodeficiency Virus (HIV) inflammation and pathogenesis. Highly Active Antiretroviral Therapy (HAART) maintains low HIV viral load (VL) but chronic inflammation remains high in HIV subjects compared to HIV naïve population. To date, there is no surrogate biomarker that gives the hallmark picture of immune activation, chronic inflammation in HIV programs. This study aimed at determining the plasma cytokine levels and their association with HIV VL at initiation and after six months on HAART in Rwanda. Methods: We used a matching groups approach based on sex and systematic sampling within the groups were used to enrol fifty (50) patients in each group. Fifteen (15) HIV naive people were included in the study as control group. BD Flow cytometry was used to determine cytokine levels while revised WHO questionnaire was used to collect socio-demographic and clinical data. Independent sample T tests (T) and Wilcoxon rank (W) were used to compare cytokine mean levels while Pearson's Product Moment Coefficient (PPMC) r was used for correlation of parameters at HAART initiation and after six months of treatment. The statistically significant differences and the correlation between assessed parameters were determined at p ≤0.05. Results: At the initiation of HAART, Interleukin (IL)-10, IL-6 plasma levels were higher while IFN-γ and TNFα were lower compared to its levels after six months of HAART. The present study found a positive association between IL-10, IL-6 and HIV VL. Conclusion: Proinflammatory and antinflammatory cytokines levels change differently following HAART and correlate with the HIV VL. The IL-10, IL-6 plasma levels are an alternative biomarker for assessment of hallmark of immune activation and inflammation in HIV infection.