Plasma cytokine levels and activated t cell markers in human immunodeficiency virus positive individuals in Rwanda

Abstract

Background: Cytokines network impact on Human Immunodeficiency Virus (HIV) pathogenesis, viral latency; infection reservoirs; persistent immune activation and chronic inflammation. Highly Active Antiretroviral Therapy (HAART) maintains low HIV Viral Load (VL) but immune activation level and chronic inflammation remain high in HIV infected /AIDS individuals compared to HIV naïve population. Immunological markers to assess immune status, chronic inflammation in HIV infected /AIDS individuals have not been resolved. Objective: To determine plasma cytokine levels, peripheral T cell activation markers and their relationship with HIV VL in HIV infected /AIDS individuals initiating and those who had completed six months on HAART in Rwanda. Methods: This was a comparative cross sectional study in HAART naïve and with HAART for six months for population above 18 years in five provinces of Rwanda. The matching groups approach based on sex and systematic sampling within the groups were used to enroll fifty patients in each group. Fifteen HIV naive individuals were included in the study as controls. Flow cytometry was used to determine cytokine levels and T cell activation markers expression while a revised WHO questionnaire was used to collect sociodemographic and clinical data for study subjects. R Studio statistic package and graph Pad Prism 7 package were used for descriptive and analytical statistic of the data at initiation and after six months of HAART treatment to address specific objectives. Statistical significance differences and the correlation between assessed parameters were determined at p-value ≤0.05. Results: At the initiation of HAART, Interleukin (IL)-2, IL-10, IL-6 plasma levels, Cluster of Differentiation (CD)69, CD154 expression were high while IFN-γ and TNF-α were low compared to its levels after six months HAART. There was no statistically significant difference between CD69 and CD154 activation markers coexpression on CD8+T cell at initiation and after six months of HAART (p-value = 0.167). IL-10, IL- 6 and CD69 expression on CD4+T cell correlated more with HIV VL (p value = 0.001). Conclusions: Th-2 cytokines milieu mediate HIV/AIDS immunity before HAART and tended to shift to Th-1 cytokines milieu following successful HAART treatment after six months. CD69 and CD154 express differently on T cells at initiation and after six months of HAART. IL- 6, IL-10 plasma level and CD69 T cell activation markers are good correlate for HIV VL. Recommendations: This study recommended IL-10, IL-6 plasma levels and CD69 expression on CD4+T cell as alternative immunological biomarkers and a longitudinal study design that to address cytokine levels, T cell activation markers expression and T cell exhaustion in HIV/AIDS.