title: Cytokine expression during syphilis infection in HIV-1-infected individuals.
abstract: BACKGROUND
  Little is known about cytokine responses to syphilis infection in HIV-1-infected individuals.
  
  
  METHODS
  We retrospectively identified patients with HIV-1 and Treponema pallidum coinfection. Plasma samples from before, during, and after coinfection were analyzed for interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha.
  
  
  RESULTS
  Thirty-six patients were included. IL-10 levels increased significantly in patients with primary or secondary stage syphilis from a median of 12.8 pg/mL [interquartile range (IQR), 11.0-27.8] before infection to 46.7 pg/mL (IQR, 28.4-78.9) at the time of diagnosis (P = 0.027) and decreased to 13.0 pg/mL (IQR, 6.2-19.4) after treatment of syphilis (P <0.001). TNF-alpha levels showed no significant change from before to during syphilis in patients with primary or secondary stage syphilis (median 3.9 pg/mL (IQR, 3.3-9.6) and 9.0 pg/mL (IQR, 5.4-12.6), respectively (P = 0.31); however, treatment of syphilis was associated with a significant decrease in TNF-alpha to a median of 4.2 pg/mL (IQR, 2.7-6.8) (P <0.001). No significant changes in cytokine levels were observed in coinfected with latent stage syphilis.IL-10 and TNF-alpha levels correlated positively with plasma HIV RNA values at the time of diagnosis (r = 0.38, P = 0.023, and r = 0.64, P <0.001, respectively) and correlated inversely with CD4 T cell counts (-0.35, P = 0.036 and r = -0.34, P = 0.042, respectively).
  
  
  CONCLUSIONS
  HIV-1 and early stage syphilis coinfection were associated with an increase in IL-10. IL-10 and TNF-alpha both decreased after treatment of syphilis. TNF-alpha and IL-10 correlated with low CD4 T cell counts and high plasma HIV RNA values.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Knudsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Benfield
authors.forename: Kristian
authors.initials: K
authors.lastname: Kofoed
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D016207:Cytokines / Q000096:biosynthesis / Q000097:blood*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000276:immunology*; D015497:HIV-1; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis / Q000097:blood; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012189:Retrospective Studies; D013587:Syphilis / Q000097:blood* / Q000150:complications; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis / Q000097:blood; D015854:Up-Regulation
chemical_list: D016207:Cytokines; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10