Nutritional Status Impairments in HIV-Infected Patients Are Associated with Increased TNF-[alpha] and IL-6 Serum Levels but Not with Viral Load

Byline: M.C.G. Galhardo (1), M.G.C. de Carvalho (1), I. Georg (1), M. Perez (2), M.G. Morgado (3), L.M.S. de Azevedo (4), E.P. Sampaio (5), E.N. Sarno (5) Keywords: Key Words HIV; Tumor necrosis factor-[alpha]; Interleukin-6; Malnutrition; Viral load Abstract: Background: Cytokines may alter metabolic pathways and contribute to malnutrition among human immunodefiency virus (HIV)-positive individuals. Patients and Methods: Tumor necrosis factor-[alpha] (TNF-[alpha]), interleukin-6 (IL-6), soluble IL-2 receptors (sIL-2R), [beta].sub.2-microglobulin serum levels and plasma viral load of 45 HIV-positive patients were determined and correlated to nutritinal status impairment. Patients were grouped by CD4 counts into categories I (&lt 200/ul), II (200--499/ul), III (aY= 500/ul). There were 15 healthy controls. A nutritional grading system, based on anthropometric and laboratory data, was devised. Scores ranged from 0 to 5 (eutrophic to malnutrition). Results: AIDS patients' cytokines and immune marker levels were significantly higher than those of the controls, but not always higher than those of other categories. AIDS patients had higher nutritional deficit grades than category III (p &lt 0.05) or the controls (p &lt 0.02) which, except for viral load, correlated with the parameters studied. Conclusion: Nutritional status impairments in HIV-positive individuals were associated with immune activation but not with viral load. Author Affiliation: (1) Centro de Pesquisa Hospital Evandro Chagas, Fundacao Oswaldo Cruz, Avenida Brasil 4365, Rio de Janeiro, 22045-900 Brazil Fax: (+55/21) 5909988, e-mail: mclara@cpqhec.fiocruz.br, BR (2) Departamento de Medicina Preventiva, Nucleo de Estudos em Saude Coletiva Universidade Federal do Rio de Janeiro, Brazil, BR (3) Laboratorio de AIDS &amp Imunologia Molecular-Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, Brazil, BR (4) Servico de Dermatologia, Hospital Universitario Clementino Fraga Filho/Universidade Federal do Rio de Janeiro, Brazil, BR (5) Laboratorio de Hanseniase-Instituto Oswaldo Cruz, Fundacao Oswaldo Cruz, Brazil, BR Article note: Received: June 27, 2000 * Revision accepted: June 30, 2001