Interferon-Gamma, Interleukin-10 And Adiponectin As Disease Progression Markers In Hiv-1 And Tuberculosis Co-Infected Non-Injection Drug Users From Mombasa, Kenya

ABSTRACT

Both HIV and TB as well as substance use cause profound dysregulation in the production of inflammatory cytokines such as adiponectin, interleukin-10 (IL-10) and interferon-gamma (IFN-γ). Although there are marked immunologic alterations in HIV and TB co-infected patients, IFN-γ, IL-10 and adiponectin levels, and their association with clinical correlates of disease such as CD4 counts, HIV-1 viral loads and BMI has not been examined in Kenyan HIV and TB co-infected non-injection substance using patients. Therefore, this cross-sectional study determined circulating IFN-γ, IL-10 and adiponectin levels in substance users at Bomu hospital, Mombasa, Kenya. The study groups included; HIV-1 and TB co-infected antiretroviral treatment (ART)-naive (n=12) and -exposed (n=9); HIV-1 mono-infected ART-naive (n=21) and ART-exposed (n=6); TB mono-infected (n=5); and uninfected substance users (n=32); and healthy controls (n=27). Demographic, anthropometric and clinical measures were recorded at enrolment of the study participants. Venous blood was collected from each participant followed by centrifugation to obtain plasma that was stored at -800C until used for cytokine and viral load measurements. CD4+ T cell counts were enumerated using a FACSCaliburTM flow cytometer on whole blood while Abbot m200-RT-PCR was used to determine HIV-1 RNA copies. TB was assessed on sputum using acid-fast staining procedure while plasma cytokine concentrations were measured using a sandwich ELISA. Statistical comparisons across-groups for continuous variables were performed using non-parametric ANOVA (Kruskal Wallis) tests followed by post-hoc Dunn’s corrections for multiple comparisons. Spearman’s rank correlation tests were used to determine the association of IFN-γ, IL-10 and adiponectin with viral loads, CD4+ T cell counts and body mass index (BMI). IFN-γ levels differed across the study groups (P