Main Article Content
A study to evaluate the levels of interferon-gamma, interleukins 6 and 10, hepcidin, iron status and some haematological parameters in persons living with human immunodeficiency virus was carried out. A total of 2000 subjects aged 18-60 years were enlisted for this study. The subjects were grouped into: Group A (100 PTB-HIV subjects on baseline) and Group B (100 PTB-HIV subjects on treatment for 60 days). About 7ml of venous blood were collected from each subject; 4.5 ml of blood were placed into plain tubes for assay of interferon gamma, interleukins (6 &10), hepcidin and iron and 2.5 ml for FBC, CD4 count and HIV screening. The cytokines and hepcidin were measured using Melsin ELISA Kits and Teco Diagnostics kits used for iron. Full blood count was determined by automation using Mindray BC-5300, China. The data was analysed with the statistical package for social science (SPSS) version 20 using ANOVA and the level of significance set at P<0.05. The results showed significant difference in IFN-γ (P=0.000), IL-6 (P=0.000) IL-10 (P=0.000), hepcidin (P=0.000), Iron (P=0.004), TIBC (P=0.000), WBC (P=0.029), Neutrophils (P=0.011), Lymphocyes (P=0.000), Monocytes (P=0.000), Basophil (P=0.013), RBC (P=0.000), Haemoglobin (P=0.000), PCV (P=0.000), MCV (P=0.029), MCH (P=0.000), MCHC (P=0.000), Platelets (P=0.000), ESR (P=0.000) and no significant difference in CD4 (P=0.966), %TSA (P=0.998) and Eos (P=0.052) when compared among PTB-HIV on baseline and 60 days on treatment respectively. The study shows that interferon gamma, interleukin 6, interleukin 10 and hepcidin are adjuncts to some of the biomarkers in the pathogenesis of pulmonary TB and HIV infection. The cytokines and hepcidin can be used as prognostic and diagnostic markers as their levels decreased with i60 days of treatment of the patients.The haemtological parameters like haemoglobin, RBC and PCV increased significantly within 60 days of treatment showing improvement in health status of the patients.
Getahun H, Gunneberg C, Granich R, Nuun. HIV infection-associated tuberculosis: the epidemiology response. Clinical Infectious Disease. 2010;50:201-207.
Gangaidzo IT, Moyo VM. Mvundura E, Aggrey G, Murphree NL, Khumalo H, Saungweme T, Kasvosve I, Gomo ZA, Rouault T. Association of pulmonary tuberculosis with increased dietary iron. Journal of Infectious Diseases. 2001;184:936-939.
Friis H, Range N, Kristensen CB, Kæstel P, Changalucha J, Malenganisho W, Krarup H, Magnussen P, Andersen AB. Acute- phase response and iron status markers among pulmonary tuberculosis patients: a cross-sectional study in Mwanza, Tanzania. British Journal of Nutrition. 2009;102:310–317.
Lado FL, Barriogo’mez E, Arceo EC, Carbarcosortizdebarro’n A. Clinical Presentation of Tuberculosis and the Degree of imunodeficiency in Transducer Glycoprotein 130. Journal of Immunology. 1999;164;273-282.
Atreya R, Mudter J, Finotto S. Blockade of interleukin 6 trans signaling suppresses T-cell resistance against apoptosis in chronic intestinal inflammation: Evidence in Crohn disease and experimental colitis in vivo. Nature Medicine. 2012;6:583–588.
Armah KA, McGinnis K, Baker J. HIV status, burden of comorbid disease, and biomarkers of inflammation, altered coagulation, and monocyte activation. Clinical Infectious Disease. 201;255:126–136.
Mihret A, Abebe M. Cytokines and Chemokines as Biomarkers of Tuberculosis. Journal of Mycobacteria Disease. 2013;3:128.
Cheesbrough M. District Laboratory Practice in Tropical Countries Part 2 (2nded.).Cambridge University Press. 2006;253-266.
Akira S, Isshiki H, Sugita T. A Nuclear Factor for IL-6 Expression (NF-1L6) is a Member of a C/EBP Family. European Molecular Biology Organisation Journal. 1990;9:1897-1906.
Breen EC. Pro and anti-inflammatory cytokines in human immunodeficiency virus infection and acquired immunodeficiency syndrome. Pharmacology and Therapeutics Journal. 2002;95:295-304.
Deveci F, Akbulut HH, Turgut T, Muz MH. Changes in Serum Cytokine Levels in Active Tuberculosis with Treatment. Mediators of Inflammation. 2005;5:256-262.
Moore KW, de Waal Malefyt R, Coff man RL, O’Garra A. Interleukin- 10 and the interleukin-10 receptor. Annual Revision of Immunology. 2001;19:683–765.
Lago PM, Boechat N, Migueis DP, Almeida AS, Lazzarini LC, Saldanha MM. Interleukin-10 and Interferon-gamma Patterna during Tuberculosis Treatment: Possible Association with Recurrence. International Journal of Tuberculosis and Lung Disease. 2012;16(95):656-659.
Boussiotis VA, Tsai EY, Yunis EJ, Thim S, Delgado JC, Dascher CC. IL-10 Producing T Cells Suppress Immune Responses in Anergic Tuberculosis Patients. Journal of Clinical Investigations. 2000;105(9):1317-1325.
Armitage AE, Eddowes LA, Gileadi U. Hepcidin Regulation by Innate Immunity and Infectious Stimuli. Blood. 2011;118: 4129-4139.
Ganz T, Nemeth E. Hepcidin and iron homeostasis. Biochimica et Biophysica acta. 2012;1823:1434-1443.
McDermid JM, Jaye A, Schim van der Loeff MF, Todd J, Bates C. Elevated Iron Status Strongly Predicts Mortality in West African Adults with HIV Infection. Journal of Acquired Immune Deficiency Syndromes. 2007;46:498-507.
Kanda J, Mizumoto C, Kawabata H, Tsuchida H, Tomosugi N. Serum Hepcidin Level and Erythropoietic Activity after Haematopoietic Stem Cell Transplantation. Haematologica. 2008;93:1550-1554.
Grigoleit HG, Lehrach F, Miller R. Diabetic angiopathy and blood viscosity. Acta Diabetology. 1973;1:1311-1323.
Godfrey F, Quigley P, Ayles M, Mwinga H, Hosp A, Porter M. Screening people living with HIV before tuberculosis preventative therapy. AIDS.1999;13:2190-2191.
Kemya MR, Semitala FR, Quinn TC, Ronald A, Meya DN, Kizza HM, Katabira ET, Space LA. Total lymphocyte count of 1200 is not a sensitive predictor of CD4 lymphocyte countamong patients with HIV disease in Kampala, Uganda. African Health Science. 2004;4:94-101.
Berkowitz FE. Hemolysis and infection: categories and mechanisms of their interrelationship. Review of Infectious Diseases. 1991;13(6):1151–62.
Baynes R, Flax H, Bothwell T, Bezwoda W, MacPhail A, Atkinson P. Haematological and ironrelated measurements in active pulmonary tuberculosis. Scandinavian Journal of Haematology. 1986;36(3):280–7.
Dosumu E. Pattern of some haematological indices in newly diagnosed pulmonary tuberculosis cases in Iwo, Nigeria: diagnostic and therapeutic implications. Nigerian Journal Medicine. 2000;10(1):18– 20.