Baseline Levels of Interleukine-6, Tumor-Necrosis Factor-Alpha and C-Reactive Protein in Treatment Naive Human Immunodeficiency Virus Infected Patients-A Study from a Tertiary-Care Hospital in Eastern India

Background: Inflammatory cytokines play a major role in pathophysiology, prognosis and progression in HIV infection. Studies on pre-ART levels of different pro-inflammatory and coagulation markers have shown predictive role on progression and mortality in HIV. IL-6, CRP has also been shown to be correlated with HIV-RNA levels as disease progresses. Objective: Biomarkers of inflammation are of increasing interest as predictors of morbidity and mortality in HIV infected patients. Though India is a major contributor to HIV-related mortality in Asia and Pacific zone, studies on inflammatory markers predictive of progression of HIV disease, on population from the Indian sub-continent are few. In this study, we observed the baseline levels of inflammatory cytokines among treatment naïve HIV positive subjects in respect to healthy volunteers. Materials and Methods: Serum levels of IL-6, TNF-α and CRP in 130 antiretroviral naive, HIVpositive individuals were estimated using sandwich ELISA, along with routine CD4 cell count, plasma HIV-1 viral load and biochemical tests for clinical assessment. Cytokine levels between ‘study’ and ‘control’ arms (30 age & gender matched HIV-negative healthy volunteers) were compared. Independent unpaired t-test was done using Graph Pad Prism 6.0 to analyze differences statistically. Results: Baseline cytokine levels were significantly high (p ≤ 0.05) in ARV naive HIV-positive subjects compared to healthy controls. Cytokine levels among treatment naive patients also correlated with severity of immunosuppression. Conclusion: Biomarkers of inflammation (IL-6, TNF-α) and CRP were found to be high in ARV naïve HIV-positive subjects, enrolled at an Eastern Indian tertiary hospital. Extensive studies on baseline inflammatory profile of patients may be predictive of disease progression, treatment response and mortality.