Changes in the immune status of HIV-infected individuals with chronic toxoplasmosis infestation and toxoplasmosis encephalitis

I.H. Hryzhak


Background. Invasion of Toxoplasma gondii in human immunodeficiency virus (HIV) infected persons may cause more profound immunodeficiency, which may contribute to the reactivation of bradyzoites and development of severe opportunistic infections. The aim of our work was to study the features of the immune status of HIV-infected patients, who infested with Toxoplasma and to define the predictors of brain toxoplasmosis. Materials and me­thods. The study involved 61 HIV-positive people (33 individuals seropositive for toxoplasmosis and 28 — seronegative). Enzyme-linked immunosorbent assay was used for determining the titers of specific anti-Toxoplasma gondii immunoglobulin G (IgG) and IgM; total IgM, IgA, IgG, and interleukin-2 (IL-2), IL-4, IL-10, interferon-γ (INF-γ), tumor necrosis factor-2α (TNF-2α). Statistical analysis was performed in statistical software packages Excel using Student’s t-test and Fisher’s z-test, statistical analysis was conducted by Bayes and consistent A. Wald method. Results. In HIV-infected persons, we have identified an imbalance of cytokines compared with healthy individuals. The seronegative for toxoplasmosis patients had elevated levels of IL-4 (1.57 ± 0.30 pg/ml vs. 0.81 ± 0.09 pg/ml, р < 0.001), IL-10 (9.81 ± 0.17 pg/ml vs. 6.70 ± 0.13 pg/ml, р < 0.001), TNF-2α (2.89 ± 0.08 pg/ml vs. 1.90 ± 0.04 pg/ml, р < 0.001), INF-γ (9.30 ± 0.47 pg/ml vs. 4.13 ± 0.12 pg/ml, р < 0.001), and total IgG (20.63 ± 0.65 g/l vs. 16.30 ± 0.94 g/l, р < 0.001). In seropositive individuals, the rates of IL-10 were higher then in seronegative ones (11.88 ± 0.50 pg/ml vs. 9.81 ± 0.17 pg/ml, р < 0.05), as well as INF-γ (10.75 ± 0.44 pg/ml vs. 9.30 ± 0.47 pg/ml, р < 0.05). Combination of 2 features: INF-γ < 8.8 pg/ml and IL-4 < 0.77 pg/ml; or INF-γ < 8.8 pg/ml and IL-10 > 11.8 pg/ml; or 3 signs — IL-4 < 0.77 pg/ml, IL-10 > 11.8 pg/ml and IL-2 < 1.5 pg/ml — is predictive in terms of the development of toxoplasmosis encephalitis. Conclusions. It was found that HIV-positive people have elevated levels of certain pro-inflammatory (TNF-α, INF-γ) and anti-inflammatory (IL-4, IL-10) cytokines, but in people seropositive for toxoplasmosis compared to seronegative ones, the indicators of INF-γ and IL-10 dominated. A manifestation of profound immunopathology and a predictor of toxoplasmosis encephalitis is the reduction of INF-γ, IL-4, IL-2 with increased IL-10 level in seropositive persons.


HIV-infection; brain toxoplasmosis; cytokines; immunopathology


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