Abstract:
Background: Cytokines play an important role in signaling the immune system to build an adequate immune response
against HIV. HIV distorts the balance between pro and anti-inflammatory cytokines causing viral replication. Highly active
antiretroviral treatment (HAART) acts by trying to restore pro and anti-inflammatory cytokine balance. It is not clear how
HAART non-adherence influences circulating cytokine levels. This study therefore determined cytokine levels in HAART
non-adherent individuals.
Methods: This cross-sectional study recruited 163 participants (51 controls, 23 HIV-1+ HAART naive, 28 HAART-adherent 6 months, 19 HAART-adherent 12 months and 42 HAART non-adherent). Cytokines were analyzed by ELISA while
CD4 T cells determined in 3.0 μl of whole blood using BD FACSCaliburTM and viral load in 0.2ml plasma sample using
Abbott Molecular m2000sp sample preparation and m2000rt real-time amplification and detection systems (Abbott Molecular Inc., Illinois, USA) according to the manufacturer’s methods.
Results: IL-4, IL-6, IL-10, TNF-α and TGF-β were significantly elevated in HIV-1 HAART non-adherent compared with
HIV-1 HAART adherent and healthy controls P<0.01. IFN- γ was significantly decreased in HIV-1 HAART non-adherent
compared with HIV-1 HAART adherent and healthy controls P<0.01. TNF-α and TGF-β were significantly reduced in HIV1 HAART adherent patients at 12 months compared to those at 6 months P<0.01. IL-4 and IL-10 correlated positively with
viral load. IL-4, IL-6, IL-10, TNF-α and TGF- β associated inversely with CD4 T cell counts and body mass index (BMI).
Conclusion: This study established that HAART adherence is immunologically beneficial to the pro and anti-inflammatory
cytokine balance milieu while non-adherence appears to cause alterations in pro and anti-inflammatory cytokines warping
the balance in this dichotomy
