Interleukin-6 and platelet protagonists in T lymphocyte and virological response.
The present cross-sectional study evaluated the status and relationship of interleukin-6, a platelet growth factor, with platelet counts, viral load, CD4 counts, and antiretroviral treatment in 75 HIV-infected subjects with thrombocytopenia and 50 gender-, race-, age- and antiretroviral treatment-matched controls without thrombocytopenia. Mean IL-6 production was significantly higher in thrombocytopenic participants (13 432+/-8596) than in non-thrombocytopenic subjects (12 859+/-3538 pg/10(5) Lym). Univariate analyses indicated, however, that thrombocytopenic patients were more likely to have <3000 pg of IL-6 than non-thrombocytopenic patients (OR=7 95% CI 1.3-12; P=0.01). For additional analyses, participants were dichotomized above and below 3000 pg of IL-6. Despite similar age, gender, drug use and antiretroviral treatment, thrombocytopenic participants had lower CD4 counts (186.5+/-149 vs. 401+/-286, P=0.005) than non-thrombocytopenic subjects. Thrombocytopenic participants with elevated IL-6, with or without HAART, were more likely to have higher HIV-replication (496 273+/-210 416; 34 656+/-25 332) than thrombocytopenic individuals with low IL-6 levels (105 332+/-42 699; 19 015+/-14 296 P=0.05). Non-thrombocytopenic patients with high IL-6 levels exhibited the highest CD4s (466.7+/-333) and the lowest viral burden (63 094+/-53 300) of the groups. Two distinct categories of HIV-associated thrombocytopenia exist: one accompanied by low IL-6, and another with compensatory elevations of IL-6. In thrombocytopenic individuals, the latter was associated with the poorest immunological and virological responses.
Miguez
Maria Jose
MJ
Department of Psychiatry, Division of Disease Prevention, University of Miami, School of Medicine, Miami, FL 33136, USA. mmiguez@med.miami.edu
Rodríguez
Allan
A
Hadrigan
Sonya
S
Asthana
Deshratn
D
Burbano
Ximena
X
Fletcher
Mary Ann
MA
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001792:Blood Platelets / Q000276:immunology / Q000378:metabolism; D015704:CD4 Antigens / Q000097:blood / Q000276:immunology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood* / Q000276:immunology / Q000821:virology*; D019562:Viral Load
D015704:CD4 Antigens; D015850:Interleukin-6