ART Regimen and Other Sociodemographics Do Not Affect Cytokine Expression in HIV Patients in Ghana

BACKGROUND: HIV infection is marked by the production of cytokines by infected cells and cells of the immune system. Variations in the levels of cytokine in HIV-infected individuals significantly impact the role of the immune system with the possibility to affect the course of HIV disease by either exacerbating or suppressing HIV replication. AIM: The study sought to investigate the effect of sociodemographic indices, clinical laboratory parameters, and ART regimen on Th1, Th2, and Th17 cytokines in HIV patients. MATERIALS AND METHODS: A total of two hundred (200) HIV patients on either the first or second line of ART were recruited into the study. Sociodemographic indices were collected using researcher-administered questionnaires. Serum concentrations of two major immune-promoting cytokines, IL-12 and IFN-γ, and immune-suppressive cytokines, IL-10 and IL-17, were measured using enzyme-linked immunosorbent assay (ELISA). T-test and chi-square were used to compare mean scores, while correlation (Pearson's correlation) and linear regression analyses were also performed with the statistical significance set at p < 0.05. RESULTS: The mean age of the participants was (45.54 ± 0.7846) years with a greater proportion (84.5%) between 31 and 60 years. The mean interferon-gamma (INF-γ), interleukin- (IL-) 10, interleukin-12, and interleukin-17 were estimated to be 349.9 ± 8.391 pg/ml, 19.32 ± 0.4593 pg/ml, 19.23 ± 0.3960 pg/ml, and 24.6 ± 0.6207 pg/ml, respectively. Although INF-γ and IL-17 levels were relatively higher in males compared to females, it was vice versa for IL-10 and IL-12. However, none of these was statistically significant. Again, no significant difference was observed among all the cytokines stratified by the duration of ART, stage of HIV, and smoking status. Most importantly, stratification by either first- or second-line ART regimens recorded no significant difference in cytokine levels. Age significantly correlated inversely with IFN-γ (r = −0.27, p ≤ 0.001), IL-10 (r = −0.24, p ≤ 0.001), and IL-12 (r = −0.18, p=0.01) while duration on ART significantly correlated inversely with IFN-γ (r = −0.16, p=0.02). CD4 counts at 6 months and 12 months on ART correlated inversely with IL-17 (r = −0.17, p=0.02) and plasma viral load at 1 year (r = −0.22, p ≤ 0.001), respectively. A positive correlation was observed between IFN-γ and IL-12 (r = −0.84, p ≤ 0.001) and IL-17 (r = −0.50, p ≤ 0.001). This positive trend was repeated between IL-10 and IL-12 (r = −0.92, p ≤ 0.001) and IL-17 (r = −0.61, p ≤ 0.001). CONCLUSION: The levels of IFN-γ, IL-12, IL-17, and IL-10 are not significantly affected by sociodemographics and ART regimen. This observation shows that no significant difference was observed in cytokine levels stratified by ART regiments. This means that both regimens are effective in the suppression of disease progression.