title: [The role of immune factors in the progression of chronic kidney diseases in HIV infection].
abstract: OBJECTIVE
  To determine the significance of immune factors in the pathogenesis of kidney injuries in HIV infection, by investigating the cellular and cytokine components of an immune response.
  
  
  METHODS
  Thirty HIV-infected patients (mean age 31.7±6.2 years) with chronic kidney disease (CKD) were examined. A comparison group consisted of 10 HIV-infected patients without signs of kidney injury. A control group included 24 healthy individuals to analyze immune status and 15 people to estimate the normal values of the cytokine composition. The cellular composition of lymphocytes on a typical immunogram was determined on a flow cytofluorometer; the serum concentrations of cytokines were measured on a multichannel photometer.
  
  
  RESULTS
  The HIV-infected patients with kidney injury displayed significant reductions in the absolute (0.2·109/l and 0.4·109/l, respectively; р=0.015) and relative (14.75 and 22%, respectively; р=0.005) counts of CD3+/CD4+ cells and in the immunoregulatory index (0.2 and 0.4, respectively; р=0.014) as compared to those in HIV-infected patients without kidney disease (р≤0.05) with a rise in the number of cytotoxic T cells (CD3+/CD8+). The HIV-infected patients showed a preponderance of immunosuppressive cytokine compositions, as indicated by the high levels of transforming growth factor-β (a more than 50-fold increase) and by a statistically significant rise in the level of tumor necrosis factor-α (TNF-α) (with CD4+ lymphocyte counts more or less than 200 cells/µl - 19.0 and 24.2 pg/ml, respectively; p=0.017; with HIV RNA levels more and less than 100,000 copies/ml - 24.4 and 19.7 pg/ml, respectively; p=0.012).
  
  
  CONCLUSIONS
  The HIV-infected patients with CKD developed kidney injury in the presence of a more pronounced decrease in blood T helper lymphocyte subpopulation levels with a predominance of proinflammatory and immunosuppressive responses. TNF-α in combination with immunosuppression and high viral loads was established to play a leading role in the development of kidney injury in HIV infection.
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
authors.forename: N D
authors.initials: ND
authors.lastname: Yushchuk
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
authors.forename: M M
authors.initials: MM
authors.lastname: Gadzhikulieva
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
authors.forename: I P
authors.initials: IP
authors.lastname: Balmasova
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
authors.forename: G V
authors.initials: GV
authors.lastname: Volgina
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
authors.forename: M M
authors.initials: MM
authors.lastname: Gultyaev
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000276:immunology*; D000328:Adult; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000276:immunology*