Department of Parasitology, Aggeu Magalhães Institute-Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil.
Curso de medicina, Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Pernambuco, Brazil.
PLoS Negl Trop Dis. 2022 Jun 17;16(6):e0010542. doi: 10.1371/journal.pntd.0010542. eCollection 2022 Jun.
Visceral leishmaniasis (VL) remains an important infectious disease worldwide. VL-HIV coinfected individuals can present with atypical clinical forms of VL and have a high risk of VL relapse. Some cytokines have been described as potential markers to diagnose active VL and to predict the severity of the cases. However, few studies have included VL-HIV coinfected patients. We aimed to characterize the levels of several cytokines among VL-HIV coinfected individuals living in a VL-endemic area in Northeast Brazil.
This was a retrospective, cross-sectional study, aiming to estimate the levels of various cytokines in symptomatic and asymptomatic VL-HIV coinfected individuals. There were 134 study participants (35 symptomatic VL-HIV, 75 asymptomatic VL-HIV, and 24 healthy controls), all ≥ 18 years-old. Serum cytokine levels (interferon-γ, tumor necrosis factor, and interleukins 2, 4, 6, 10, and 17A) were quantified using the Becton Dickinson-BD's Cytometric Bead Array (CBA) system.
The population mainly consisted of men (64.9%), with a median age of 35 (27-41) years. Asymptomatic individuals were younger (p = 0.013), with more years of education (p < 0.001), and were more often on antiretroviral therapy (p < 0.001) than those in the symptomatic group. Hemoglobin levels (p < 0.001), lymphocytes (p < 0.001) and CD4 count (p < 0.001) were lower in symptomatic individuals, while HIV viral loads were higher (p < 0.001). In the symptomatic VL-HIV coinfected group, we observed increased serum levels of IL-17A, IL-6, and IL-10 compared to asymptomatic patients and the healthy controls. There were no differences in the levels of all cytokines between asymptomatic VL-HIV coinfected individuals and the healthy controls.
Higher serum levels of IL-17A, IL-6, and IL-10 cytokines were observed in symptomatic coinfected individuals but not in asymptomatically infected individuals. More studies among HIV-positive persons are needed to better understand the role of serum cytokines for prognosis, to define cure and predict VL relapses in VL-HIV coinfected individuals.
内脏利什曼病（VL）仍然是全球重要的传染病。VL-HIV 合并感染的个体可能表现出非典型的 VL 临床形式，并且具有较高的 VL 复发风险。一些细胞因子已被描述为诊断活动性 VL 和预测病例严重程度的潜在标志物。然而，很少有研究包括 VL-HIV 合并感染的患者。我们旨在描述生活在巴西东北部 VL 流行地区的 VL-HIV 合并感染个体中几种细胞因子的水平。
这是一项回顾性、横断面研究，旨在估计有症状和无症状 VL-HIV 合并感染个体中各种细胞因子的水平。共有 134 名研究参与者（35 名有症状的 VL-HIV、75 名无症状的 VL-HIV 和 24 名健康对照），年龄均≥18 岁。使用 Becton Dickinson-BD 的 Cytometric Bead Array（CBA）系统定量血清细胞因子水平（干扰素-γ、肿瘤坏死因子以及白细胞介素 2、4、6、10 和 17A）。
该人群主要由男性（64.9%）组成，中位年龄为 35（27-41）岁。无症状个体更年轻（p=0.013），受教育程度更高（p<0.001），并且更常接受抗逆转录病毒治疗（p<0.001）。与有症状组相比，无症状个体的血红蛋白水平（p<0.001）、淋巴细胞计数（p<0.001）和 CD4 计数（p<0.001）更低，而 HIV 病毒载量更高（p<0.001）。在有症状的 VL-HIV 合并感染组中，与无症状患者和健康对照组相比，我们观察到血清中 IL-17A、IL-6 和 IL-10 水平升高。无症状 VL-HIV 合并感染个体与健康对照组之间的所有细胞因子水平无差异。
在有症状的合并感染个体中观察到更高的血清 IL-17A、IL-6 和 IL-10 细胞因子水平，但在无症状感染个体中未观察到。需要对 HIV 阳性人群进行更多研究，以更好地了解血清细胞因子在预后、确定治愈和预测 VL-HIV 合并感染个体复发中的作用。
