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Proinflammatory cytokine and human immunodeficiency virus RNA levels during early Mycobacterium avium complex
D W Haas1, M M Lederman, L A Clough
1Department of Medicine, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee 37212, USA. david.w.haas@vanderbilt.edu
Abstract:
The relationship between Mycobacterium avium complex (MAC) bacteremia and proinflammatory cytokine and human immunodeficiency virus type 1 (HIV-1) RNA levels in AIDS was investigated. During a prospective study, blood samples were drawn monthly for mycobacterial cultures. Sera were available at baseline and onset of MAC bacteremia from 20 cases and at corresponding times from 19 controls. Mean interleukin-6 (IL-6) levels were 154% greater at the time of MAC bacteremia in cases than in controls. The IL-6 levels correlated with body temperature, serum tumor necrosis factor (TNF-alpha) levels, and alkaline phosphatase levels (P < or = .004 for each). Although TNF-alpha levels tended to rise more in MAC patients than in controls, the difference was not significant. However, among both cases and controls, serum TNF-alpha levels rose significantly from baseline to the time of last sample, irrespective of MAC infection (P = .015). Bacteremia was not associated with increased serum HIV-1 RNA levels. Thus, early MAC bacteremia is associated with increases in serum IL-6 levels, while TNF-alpha levels rise over time during advanced AIDS.
Insights
Early Mycobacterium avium complex (MAC) bacteremia in AIDS patients is linked to higher interleukin-6 (IL-6) levels. Tumor necrosis factor-alpha (TNF-alpha) levels increased over time, regardless of MAC infection.
Area of Science:
- Immunology
- Infectious Diseases
- Virology
Background:
- Mycobacterium avium complex (MAC) bacteremia is a significant opportunistic infection in advanced AIDS.
- Proinflammatory cytokines play a crucial role in the pathogenesis of HIV-1 infection and its complications.
- Understanding the interplay between MAC bacteremia, cytokines, and HIV-1 RNA is vital for managing AIDS patients.
Purpose of the Study:
- To investigate the relationship between Mycobacterium avium complex (MAC) bacteremia and levels of proinflammatory cytokines, specifically interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha).
- To examine the association between MAC bacteremia and human immunodeficiency virus type 1 (HIV-1) RNA levels in patients with acquired immunodeficiency syndrome (AIDS).
Main Methods:
- Prospective study involving monthly mycobacterial cultures.
- Serum samples collected at baseline and onset of MAC bacteremia from cases and controls.
- Quantification of IL-6 and TNF-alpha levels, and HIV-1 RNA levels.
Main Results:
- Mean IL-6 levels were 154% higher at the time of MAC bacteremia in cases compared to controls.
- IL-6 levels correlated with body temperature, TNF-alpha, and alkaline phosphatase.
- TNF-alpha levels increased significantly over time in both cases and controls, irrespective of MAC infection.
- MAC bacteremia was not associated with increased serum HIV-1 RNA levels.
Conclusions:
- Early MAC bacteremia is associated with significant increases in serum IL-6 levels in AIDS patients.
- Serum TNF-alpha levels demonstrate a temporal increase during advanced AIDS, independent of MAC bacteremia.
- These findings highlight the distinct inflammatory responses to MAC bacteremia and the progression of advanced AIDS.