Immunological profiles in HIV positive patients following highly active antiretroviral treatment initiation in Kigali-Rwanda

Abstract

Changes in the cytokine networks impact HIV pathogenesis, latency and persistence. Although several studies have been done to explain these interactions, they are yet to be fully understood. In this study, levels of Interleukin-10, ILnterleukin-2, Interferon-gamma and the current markers of HIV disease progression namely CD4 count and viral load; were assessed and correlated before HAART and at six months of treatment in 33 HIV patients. The aim of the study was to assess the shift from Th1 to Th2 profile in the course of HIV disease particularly in relation to HAART in Kigali. Viral load was measured using the COBAS ® AmpliPrep/COBAS ® TaqMan ® HIV-1 Test while CD4 count and cytokines measurement were done by flow cytometry and ELISA respectively. Following HAART, there was a drop in viral load (though only a small number of patients achieved an undetectable viral load); recovery of CD4 + cells, a decrease in IL-10 (but remained high for many patients); and an increase in IL-2 and IFN-γ. CD4 count correlated negatively with viral load and IL-10 (but r < -0.5). IL-10 showed significant positive correlation with viral load at both time points (r > 0.5, p values <0.05). CD4 count did not show a statistically significant correlation with IL-2 and IFN- γ (p values >0.05). Results from this study demonstrated the down-regulatory effect of IL-10 on Th1 cytokines and that a shift from Th1 to Th2 cytokine profile is associated with progression of HIV disease. Successful HAART results in drop in viraemia and IL-10 with up-regulation of Th1 cytokines and CD4+ cells recovery. The findings from this study indicate potential usefulness of IL-10 as a marker of HIV disease progression. From the findings of the present study, it is recommended that further studies should be done to support the findings. Moreover, reference values for cytokines need to be determined.