Title:Baseline Levels of Interleukine-6, Tumor-Necrosis Factor-Alpha and C-Reactive Protein in Treatment Naive Human Immunodeficiency Virus Infected Patients-A Study from a Tertiary-Care Hospital in Eastern India
Volume: 6
Issue: 2
Author(s): Anindita Debnath, Madhuchhanda Mandal, Sayantani Choudhuri, Malay K. Saha and Subhasish Kamal Guha*
Affiliation:
- Department of Tropical Medicine, Calcutta School of Tropical Medicine, 108-C.R. Avenue, Kolkata- 700073, West Bengal,India
Keywords:
CD4 cell count, C-reactive protein (CRP), inflammatory markers, interleukine-6 (IL-6), plasma viral load (PVL),
tumor necrosis factor-α (TNF-α).
Abstract: Background: Inflammatory cytokines play a major role in pathophysiology, prognosis and
progression in HIV infection. Studies on pre-ART levels of different pro-inflammatory and coagulation
markers have shown predictive role on progression and mortality in HIV. IL-6, CRP has also been
shown to be correlated with HIV-RNA levels as disease progresses.
Objective: Biomarkers of inflammation are of increasing interest as predictors of morbidity and mortality
in HIV infected patients. Though India is a major contributor to HIV-related mortality in Asia and
Pacific zone, studies on inflammatory markers predictive of progression of HIV disease, on population
from the Indian sub-continent are few. In this study, we observed the baseline levels of inflammatory
cytokines among treatment naïve HIV positive subjects in respect to healthy volunteers.
Materials and Methods: Serum levels of IL-6, TNF-α and CRP in 130 antiretroviral naive, HIVpositive
individuals were estimated using sandwich ELISA, along with routine CD4 cell count, plasma
HIV-1 viral load and biochemical tests for clinical assessment. Cytokine levels between ‘study’ and
‘control’ arms (30 age & gender matched HIV-negative healthy volunteers) were compared. Independent
unpaired t-test was done using Graph Pad Prism 6.0 to analyze differences statistically.
Results: Baseline cytokine levels were significantly high (p ≤ 0.05) in ARV naive HIV-positive subjects
compared to healthy controls. Cytokine levels among treatment naive patients also correlated with severity
of immunosuppression.
Conclusion: Biomarkers of inflammation (IL-6, TNF-α) and CRP were found to be high in ARV naïve
HIV-positive subjects, enrolled at an Eastern Indian tertiary hospital. Extensive studies on baseline inflammatory
profile of patients may be predictive of disease progression, treatment response and mortality.
