Serum cytokine profile by multiplex immunoassay in HIV patients with neurocysticercosis: a stage-specific approach to assess the peripheral immune response.

Background: Neurocysticercosis (NCC) and human immunodeficiency virus (HIV) have high disease burden and are prevalent in overlapping low- and middle-income countries. However, little is known about how these two infections interact, its bearing on disease progression which could impact treatment guidance for people living with HIV/AIDS (PLWH/A) co-infected with NCC. Objective: To evaluate the peripheral immune response associated with T. solium neurocysticercosis in HIV patients, specifically by determining the host pro- and anti-inflammatory cytokines in neurocysticercosis and determine their possible roles as biomarkers. Methods: This on-going study recruits adults living in southern highlands of Tanzania, an area endemic for cysticercosis. Serum was obtained from HIV+ patients and their HIV- controls who were matched for gender, age and living area. Their T. solium antibodies (Ab) were measured using LDBio cysticercosis western blot IgG and antigen (Ag) status was determined using ApDia ELISA test which detects circulating antigens from viable metacestode. Neurocysticercosis (NCC) was determined by computed tomography using standard diagnostic criteria and neurological manifestations were confirmed by a standard neurological examination. The cysticercosis positive criteria was defined as: having a positive T. solium result for both antibody and antigen, antigen alone, imaging alone or a combination of suggestive imaging and positive serology. Using multiplex detection technology, sera from participants were assayed for levels of different inflammatory and regulatory cytokines. In addition, demographic, clinical and neuroimaging data were collected and CD4+ cell counts as well as information on highly active antiretroviral treatment (HAART) were noted. Results: Comparable levels of inflammatory cytokines was observed between HIV+ and HIV- people likely due to 87.7% (1125 out of 1283) being on ART. When we stratified further by T solium infection; levels of inflammatory cytokines (TNF-a, IFN-g, vCAM-1 and IL12) were significantly higher in HIV + positive individuals co infected with T solium cysticercosis compared to those not co-infected with T. solium cysticercosis (p 0.05). Among the HIV+ group, T solium cytokine concentration was not associated with CD4+ cell counts, or duration on ART. Conclusions: HIV patients co-infected with T. solium cysticercosis have an inflammatory immune response profile which may cause a poor disease prognosis. [ABSTRACT FROM AUTHOR]