Cytokine imbalance in HIV-infected children

Variability of human immune deficiency virus (HIV), as well as individual characteristics of the subjects is the reason for the failure of immune system against HIV infection. An imbalance in cytokine production occurs in HIV infection, thus leading to deterioration of immune response. Due to a variety of properties, certain cytokines may protect against HIV infection, while others contribute to the development of immunodeficiency state. At the same time, the immunodeficiency virus can promote the synthesis and production of cytokines. Our study was conducted at the Republican AIDS Center of the Republic of Uzbekistan and Institute of Immunology and Genomics (Academy of Sciences of the Republic of Uzbekistan). The diagnosis in all patients under study was confirmed clinically and by laboratory tests using ELISA and immunoblotting techniques. The HIV-infected participants were aged 9-18 years. The HIV-infected children were divided in two age groups: Group I (9-14 years old), and Group II (15-18 years old). Evaluation of IL- 4, IL-18, TNFα and IFNγ cytokines was performed in HIV-infected children aged 9-18 years. The revealed imbalance of cytokines contributed to the damage of CD4+ cells by the virus, leading to the progression of immunosuppression and subsequent development of opportunistic infections. The significantly increased levels of IL-18, TNFα, and IFNγ were found in HIV-infected children. IL-18 and TNFα have proven to be increased in the older age group, along with decreased IFNγ levels. Elevated levels of IL-18 and TNFα may suggest an active immune response to HIV. Development of chronic inflammatory processes presumes a progression of the disease and emergence of concomitant diseases. Changes in the cytokine synthesis cause dysregulation of immune response in HIV-infected children, which, in turn, may lead to increased viral replication. An increase in IL-4, IL-18, TNFα levels in adolescents, and a decrease in IFNγ during antiretroviral therapy (ART) suggests a need for studying the possible causes of these changes for each child individually, and further adjustment of treatment for HIV-infected children.

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