ANALYSIS OF CHANGES OF SERUM BETA-2-MICROGLOBULIN AND HEMATOLOGICAL PARAMETERS IN PATIENTS WITH HIV-ASSOCIATED NEUROLOGICAL DISEASES

Abstract

Patients with the fourth clinical stage of HIV infection with neurological involvement present with tendency to increase the level of serum beta-2-microglobulin (MG ) and to show significant differences in the main indicators of the hematological and immunological profile in comparison with the group of patients without involvement of the nervous system.

The aim of the study – to determine the level of 2-microglobulin and its relation to the main hematological and immunological parameters in patients of the fourth clinical stage of HIV infection in the presence or absence of diseases of the central nervous system.divided into two groups: the first group consisted of 38 patients with clinical-relevant diseases other than neurological, the second group consisted of 39 patients who had HIV-associated neurological diseases. The control group consisted of 15 healthy donors, of corresponding sex and age distribution. Determination of beta-2-microglobulin was performed by EL ISA with standard test systems (US Ave). The statistical processing of the results was carried out using the licensed software product STAT IST ICA v.6.1®.

Results and Discussion. A significant difference has been established for both markers of the immune status and hemogram indices. Among those who had neurological diseases (group 2), leucopenia was determined at 3.88 ± 0.27 g/L versus 5.07 ± 0.27 g/L (p <0.01), the mean number of platelets was 1.2 times lower (р <0.05), and the ESR index is more than 2.7 times higher (р <0.001) than in patients of the fourth clinical stage of HIV without neurological diseases (group 1). Relative and absolute number of T-lymphocytes of helpers (TL ) in patients of the group 2 was 1.9 and 3 times less than corresponding parameters in patients of the group 1 (p <0.001). Significant differences were shown in the number of lymphocytes (p <0.001) and T-lymphocytes (p <0.01). The mean viral load (VL ) of HIV RNA in patients of the group 2 (Log10 VL – 5.02 copies/ml) exceeded the index of the group 1 by more than an order of magnitude – 3.90 copeis/ml (p <0.01). The study of the marker of immune activation of в2-MG revealed a steady tendency to increase the level of this protein in patients with HIV infection in the presence of neurological diseases (p <0.05 compared to the group of patients without neurological diseases). Based on the results of the correlation analysis in patients with the fourth clinical stage of HIV infection, regardless of the presence of neurological diseases, reliable connections between the level of в2-MG and VL and immunological and hematological parameters were found. Thus, the level of this protein directly correlated with ESR (rs = 0.42, p <0.001) and the indicator of VL RNA of HIV (rs = 0.23, p <0.05). The increase in the level of β2-MG was associated with a decrease in the absolute number of TL (rs = –0.40, p <0.001) and TLH (rs = -0.39, p <0.001), the total number of lymphocytes (rs = -0.43; p <0.001) and the relative amount of TL C in the blood serum (rs = -0.36, p <0.01). More expressive were correlations in patients with HIV associated neurological diseases.

Conclusions. Patients with HIV-associated neurological diseases have significant differences in all major indicators of the hematological and immunological profile compared with the group of patients without diseases of the nervous system. The tendency to increase the level of serum β2-MG in the presence of neurological diseases in parallel with significant changes in immunological and hematological parameters can be used for the prognostic model of the development of IV-associated neurological diseases.