ABSTRACT
Human immunodeficiency virus (HIV) affects CD4+ cells, compromise immunity and exposes infected patients to opportunistic infections. Cytokines are soluble proteins that play important roles in immunity, inflammation and haematopoiesis. Information on cytokine levels in HIV infected subjects in our setting is scarce. This study was to determine the plasma levels of some cytokines in HIV infected patients and possible association with disease severity. The study was conducted at the University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. Blood samples were collected from 100 HIV positive patients on HAART, 100 treatment-naïve and 100 apparently healthy individuals. The CD4 cell count was done using cyflow counter, haematological and biochemical parameters were determined using Sysmex KX-21N and Selectra Pro-S respectively. The cytokines were determined using enzyme linked immunosorbent assay. The parameters were analyzed using unpaired Student’s T-test, Analysis of variance and Pearson’s correlation coefficient. The levels of IFN-γ, IL-6 and TNF-α were significantly higher (p<0.05) in HIV patients compared to non-HIV subjects. There was significant correlation (p<0.005) between age and IL-6 as well as between age and TNF-α in non-HIV subjects. The CD4 count of HAART-naïve HIV patients was significantly lower (p<0.001) than those of nonHIV subjects and HIV patients on HAART (p<0.001). Among the haematological parameters, significant difference (p<0.05) was observed in haematocrit, mean cell volume (MCV), mean cell haemoglobin (MCH) and lymphocyte count when values in the HIV patients were compared. Among the study population, MCV, MCH, haematocrit, Haemoglobin, and total leucocyte count showed varying levels of correlation with the studied cytokines. Significant variations were observed in albumin, alkaline phosphatase, aspartate amino transferase and conjugated bilirubin among the study population. Similarly, albumin, alkaline phosphatase, aspartate amino transferase and conjugated bilirubin showed significant correlation with TNF-α and IFN-γ. Total cholesterol and high density lipoprotein were significantly lower in HAART naïve HIV patients compared to the other study groups. There was significant correlation between IFN-γ and total cholesterol and low density lipoprotein and between IL-6 and high density lipoprotein and low density lipoprotein in HAART naïve HIV patients. Significant correlation was also observed between TNF-α and total cholesterol and low density lipoprotein in non HIV subjects. Glucose was significantly higher in HAART treated HIV patients than non HIV subjects. Creatinine was higher in HAART naïve HIV patients than non HIV subjects. The tested cytokines showed no significant correlation with CD4 count and no association with HIV disease severity. No clear cut pattern was observed in the few correlations between the tested cytokines and the investigated paramaters, albeit, the correlations were generally weak. Further studies to determine the association of cytokines with viral load as well as type of HAART and duration of use is advocated.
