Plasma cytokines, cytokine antagonists, and disease progression in African women infected with HIV-1.
OBJECTIVE
To examine the relation of circulating cytokines and cytokine antagonists to the progression of human immunodeficiency virus type 1 (HIV-1) disease.


METHODS
Cross-sectional analysis.


METHODS
An ambulatory acquired immunodeficiency syndrome (AIDS) research clinic in Kinshasa, Zaire.


METHODS
48 women with AIDS, 51 women with HIV infection who were clinically asymptomatic, and 11 female controls who did not have HIV infection, all from Zaire.


METHODS
Plasma levels of interleukin-1beta, tumor necrosis factor-alpha (TNF-alpha), interleukin-6, interleukin-8, interferon-gamma, interleukin-1beta receptor antagonist (interleukin-1Ra), and TNF soluble receptor p55 (TNFsRp55) were assayed by specific radioimmunoassays. Plasma levels of interferon-gamma were assayed by commercial enzyme-linked immunosorbent assay. The Wilcoxon rank-sum test was used to assess the significance of mean and median differences between groups.


RESULTS
Of the 48 patients with AIDS, circulating interleukin-1beta was detected in 2, TNF-alpha in 4, interleukin-6 in 3, and interleukin-8 in 12. None of these factors were seen in any of the 11 controls. Median values of interleukin-1beta (320 pg/mL), TNF-alpha (210 pg/mL), and interleukin-8 (750 pg/mL) were elevated in HIV-infected asymptomatic patients compared with patients with AIDS (2-, 2.6-, and 18.7-fold higher, respectively; P < 0.001). Interleukin-1Ra and TNFsRp55 levels were substantially higher than interleukin-1beta and TNF-alpha levels in HIV-infected asymptomatic patients (73- and 14-fold, respectively) and were higher than those in patients with AIDS (17.8- and 1.74-fold, respectively).


CONCLUSIONS
High circulating levels of the proinflammatory cytokines interleukin-1beta and TNF-alpha, combined with an excess of their natural inhibitors interleukin-1Ra and TNF-sRp55, were seen in clinically asymptomatic HIV-1-positive African women but not in African women with AIDS or in HIV-negative controls. Circulating cytokine antagonists may play a clinical role in modulating cytokine-associated symptoms in the early phases of HIV infection.
Thea
D M
DM
New England Medical Center, Boston, Massachusetts, USA.
Porat
R
R
Nagimbi
K
K
Baangi
M
M
St Louis
M E
ME
Kaplan
G
G
Dinarello
C A
CA
Keusch
G T
GT
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000037:antagonists & inhibitors / Q000097:blood*; D015023:Democratic Republic of the Congo; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000097:blood*; D006801:Humans; D009752:Nutritional Status
D016207:Cytokines