Dynamics of serum cytokines in patients with visceral leishmaniasis and HIV-1 co-infection

Serum cytokine levels and peripheral T cell subpopulations of HIV-l-infecte d patients before, during and after active visceral leishmaniasis (VL) were analysed and compared with appropriate controls. At VL diagnosis, co-infec ted patients showed higher serum levels of interferon-gamma (IFN-gamma) tha n matched HIV-I controls without VL, and lower serum concentrations of IL-1 0 than non-immunocompromised VL controls. High levels of tumour necrosis fa ctor-alpha (TNF-alpha) and IFN-gamma were present in the sera of HIV-l-infe cted patients with active VL. TNF-alpha remained elevated after VL recovery . A steady decline in the CD4(+) cell count, an increase of serum HIV virae mia and a progressive seroconversion for the HIV-1 p24 antigen was observed during the course of VL disease. Thus, an aberrant activation of the TNF s ystem with possible negative immunological and virological consequences is present in HIV-I-infected patients with VL. A more extensive prospective va lidation of these findings in a bigger cohort of patients will nevertheless be necessary. The results support the hypothesis that different opportunis tic infection agents may trigger the production of proinflammatory cytokine s during immunodeficiency, and in this way accelerate the course of HIV-1 d isease.