Potential of Interleukin 7 and CD4/CD8 Ratio as Markers of Immune Reconstitution in HIV Patients on Antiretroviral Therapy in Yaoundé, Cameroon

Cedric Happi Mbakam, Marie Claire Okomo Assoumou, Graeme Brandon Jacobs, Franklin Agueguia Azebaze, Martha Mesembe, Emilia Lyonga, Claude Tayou Tagny, George Mondinde Ikomey

Abstract



ABSTRACT
Background. Although plasma viral load is the main indicator of viral progression amongst HIV-infected patients on antiretroviral therapy, immune reconstitution remains a major challenge. Our study aimed to evaluate the potential of interleukin 7 (IL-7) and CD4/CD8 ratio as markers of immune reconstitution amongst HIV patients on antiretroviral therapy (ART) in Yaoundé, Cameroon. Methods. A cross-sectional study was conducted from July to December 2017, at the Yaoundé University Teaching Hospital. T-lymphocyte profile, IL-7 level and plasma viral load were determined using standard methods. GraphPad Prism 5.0 software was used for statistical analysis. Comparison between variables was performed using the non-parametric Kruskal Wallis test. Results. Enrolled participants were divided into ART success 110(54%), ART failure 58(30%) and Uninfected 32(16%). The mean age of treatment was 3±0.76 years. The plasma level of IL7 and CD4/CD8 ratio were statistically different amongst groups (p<0.0001). There was a direct correlation between IL-7 and viral load (r =0, 6, p =0.03, 95%CI =[0.02005 - 0.8952]). It was inverse between IL-7 and CD4 lymphocytes (r =-0.7, p =0.03, 95%CI =[-0.93 - 0.26]). There was an inverse correlation between CD4/CD8 ratio and IL-7 (r =-0.7, p =0.01, 95%CI =[-0.9255 – (-0.1961)]). Conclusion. The variation in CD4/CD8 ratio and the IL-7 level was statistically significant amongst ART failure and success patients. IL-7 and CD4/CD8 ratio were influenced by ART in both groups. They might be predictive of immunological dysfunction associated to disease progression and might be used as immunological markers in the immunological monitoring of HIV infected patients.
RÉSUMÉ
Contexte. Bien que la charge virale plasmatique soit le principal indicateur de la progression virale chez les patients VIH positifs sous traitement antirétroviral, la reconstitution immunitaire reste un défi majeur. Notre étude visait à évaluer le potentiel de l'interleukine-7 (IL-7) et du ratio CD4/CD8 comme marqueurs de l’immuno-reconstitution  chez les patients VIH sous traitement antirétroviral à Yaoundé, au Cameroun. Méthodes. Une étude transversale a été menée de juillet à décembre 2017 au Centre Hospitalier Universitaire, Yaoundé. Le profil lymphocytaire T, la concentration d'IL-7 et la charge virale plasmatique ont été déterminés par des méthodes standards. GraphPad Prism 5.0 a été utilisé pour l'analyse statistique. Le test non paramétrique de Kruskal Wallis a été utilisé pour comparer les variables. Résultats. Les participants étaient regroupés en succès thérapeutique 110 (54%), échecs thérapeutique 58 (30%) et non infectés 32 (16%). L'âge moyen du traitement était 3±0,76 ans. L’IL7 et ratio CD4/CD8 étaient différents entre les groupes (p<0,0001). Il y’avait une corrélation positive entre l'IL-7 et la charge virale (r =0,6, p =0,03, IC=[0,02005 - 0,8952]). Elle était inverse entre le ratio CD4/CD8 et IL-7 (r =-0,7, p =0,01, IC = [-0,9255 – (-0,1911)]). Conclusion. La variation du ratio CD4/CD8 et de l'IL-7 était statistiquement significative. Le ratio CD4/CD8 et IL-7  était influencé par le traitement antirétroviral dans les deux groupes. Ils pourraient prédire les dysfonctionnements immunologiques associés à la progression de la maladie et pourraient être utilisés comme marqueurs immunologiques dans la surveillance immunologique de patients infectés par le VIH.

Keywords


Interleukin 7, CD4/CD8 ratio, ART success, ART failure

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