CORRELATIONS OF CRP AND TNF-α IN HIV-POSITIVE PERSONS WITH DISEASES OF THE PULMONARY SYSTEM

Abstract

SUMMARY. Conduct a study to determine the content of inflammatory markers, CRP and TNF-α, in HIV-positive individuals with bacterial pneumonia and HIV/TB co-infection.

Patients and methods. A study of CRP and TNF-α content in the blood serum of HIV-infected persons with pulmonary lesions was conducted on the basis of the Regional Clinical Infectious Disease Hospital in Kharkiv in the department for HIV-positive persons who were undergoing inpatient treatment. The study design was a retrospective (case-control) study. The object of the study was the content of CRP and TNF-α in the serum of patients with HIV infection with lung pathology. The subject of the study was the clinical course of pulmonary pathology in HIV infection and HIV/TB co-infection. 77 patients with HIV infection with lung damage who met the specified criteria took part in the study. The average age of the patients was (38.96±0.88) years. By gender, men predominated – 51 (66.2 %). Depending on the clinical and laboratory examination data, the participants were divided into 2 groups: group 1 (44 people) – patients diagnosed with HIV infection, bacterial pneumonia; group 2 (33 people) consisted of patients with HIV/TB co-infection. The control group consisted of 31 healthy people. In order to study the quantitative parameters of TNF-α and CRP in patients with HIV infection with lung pathology, whole blood was collected from the cubital vein on the day of hospitalization, before the start of treatment. The TNF-α indicator was determined using the “sandwich” version of the solid-phase enzyme-linked immunosorbent assay with the use of mono- and polyclonal antibodies to TNF-α. The content of CRP was determined by the method based on the one-stage “sandwich” variant of solid-phase immunoenzymatic analysis using monoclonal antibodies to CRP. The reagents of JSC “Vector-Best” were used. The content of TNF-α in the experimental serum was determined in pg/ml, CRP in mg/l. Statistical analysis was carried out by the methods of variation and correlation statistics with the use of software.

Results and discussion. The content of CRP in the blood serum of patients of the I group was (9.6±0.19) mg/l and in the II group of patients (95.31±2.21) mg/l, respectively, which compared to the control – (2.29±0.09) mg/l had statistically higher indicators (p₁<0.001), however, the value of CRP in the group of patients with HIV/TB co-infection was higher (p₂<0.001) compared to group I. TNF-α values increased significantly in both studied groups: in group of patients with HIV/BP (101.77±1.79) pg/ml; p₁<0.001 and in the group of patients with HIV/TB – (9.5±0.78) pg/ml (p₁<0.001) compared to the control group, but was statistically higher in the group of patients with HIV/BP (p₂<0.001). When conducting an analysis between CRP and TNF-α indicators in the group of HIV patients with bacterial pneumonia, an inverse correlation was found (CRP/TNF-α=-0.35; p<0.02), which means that with growth of one of the indicators, the other indicator decreases. In the comparison group, no correlation was found between the studied indicators.

Conclusion. According to the results of the conducted research, we received data indicating a significant negative impact on the immunity of the human immunodeficiency virus, in which the protective reactions aimed at overcoming the bacterial infectious agent in the body of a patient with HIV infection are distorted, and in the case of combined HIV/TB infection, physiological defense reactions are not even formed.