East African Medical Journal

Log in or Register to get access to full text downloads.

Remember me or Register

Immunological profiles in HIV positive patients following Haart initiation in Kigali, Rwanda

AP Twizerimana, J Mwatha, JP Musabyimana, E Kayigi, J De Dieu Harelimana, SM Karanja, L Mutesa


Background: Interleukin-10, IL-2 and IFN -γ are some of the crucial cytokines associated with HIV infection and pathogenesis. While IL-2 and IFN-γ play critical roles in host resistance to infection, IL-10 inhibits the synthesis IFN-γ, IL-2 at mRNA and protein level; exacerbating damage to immune system.
Objective: To determine the levels of, changes in and correlation between CD4 count, viral load, IL-10, IL-2 and IFN-γ before HAART and at six months of HAART among HIV positive patients in Kigali; with a view to understand cytokine networks particularly in relation to HAART ; and to see whether they can be used as alternative markers of the disease progression.
Design: Longitudinal study.
Setting: Kagugu, Kimironko, Biryogo, Gitega Health Centres and Centre Medico-Social Cornum; all located in Kigali.
Subjects: Thirty three (33) HAART initiation eligible HIV positive patients including 13 women and 20 men.
Results: A drop in viral load (though only a small number of patients achieved an undetectable viraemia); a recovery of CD4+ cells, a decrease in IL-10 (though it remained high for many patients especially those with unchanged viraemia); and an increase in IL-2 and IFN-γ indicated a successful HAART . A negative correlation between CD4 count and viral load and between CD4 count and IL-10 (but r <-0.5) was observed. IL-10 correlated positively and strongly with viremia (r > 0.5 at both time points: p-values <0.05). There was no significant correlation between CD4 count, IL-2 and IFN-γ.
Conclusion: Results demonstrated the down-regulatory effect of IL-10 on Th1 cytokines and that a shift from Th1 to Th2 cytokine is associated with HIV disease progression. A successful HAART results in CD4+ cells recovery, drop in viraemia and IL-10 with up-regulation of Th1 cytokines. Also, findings show potential usefulness of IL-10 as a marker of HIV disease progression.

AJOL African Journals Online