Features of the cytokine profile in COVID-19 patients with human immunodeficiency virus infection

Abstract

Despite the significant number of studies devoted to the course of COVID-19 in people with HIV, the characteristics of the immune inflammatory response under this combined pathology remain controversial. In this regard, it is of particular interest to study the cytokine profile reflecting the key mechanisms of the immune-inflammatory process in COVID-19 against the background of HIV infection. The purpose — to study the cytokine profile in patients with COVID-19 and HIV infection. Material and methods. The study included 156 patients: 76 with COVID-19/HIV and 80 with COVID-19 without HIV. The control group included 26 healthy people (voluntary donors). We measured serum concentrations of 48 cytokines, chemokines and growth factors by multiplex analysis using the Bio-Plex Pro Human Cytokine Screening Panel on the MAGPIX platform. Data were presented as Me [Q1; Q3]; differences were considered significant at p < 0.05. Results. Both clinical groups demonstrated signs of systemic immune activation, but the cytokine patterns differed substantially. COVID-19 group showed increased levels of interleukin-6 (IL-6), interferon-gamma (IFN-γ), chemokine CXCL10 (CXCL10), chemokine CXCL9 (CXCL9), interleukin-8 (IL-8), chemokine CCL2 (CCL2), interleukin-10 (IL-10) and interleukin-7 (IL-7). Patients with COVID-19 and HIV infection had a different immuno-inflammatory profile: a sharp increase in interleukin-1a (IL-1a), a marked decrease in the interleukin-1 receptor antagonist (IL-1Ra), low levels of IL-8, a decrease in IL-10 and IL-7, and a persistent increase in IFN-γ-dependent chemokines CXCL10 and CXCL9. The most pronounced intergroup differences related to the IL-1 system: the median IL-1a in COVID-19 patients with HIV infection was 55.30 [48.89; 99.85] versus 2.84 [0.74; 6.23] pg/ml in isolated COVID-19. On the contrary, IL-1Ra was reduced to 0.37 [0.12; 2.67] versus 64.91 [46.00; 96.37] pg/ml. Conclusion. COVID-19 in patients with HIV infection is accompanied by an increase in general inflammation, as well as a qualitative restructuring of the cytokine response with the imbalance of the IL-1-dependent signaling pathway, a decrease in neutrophilic, regulatory components and the relative dominance of interferon-dependent inflammatory mechanisms. The most significant markers in patients with COVID-19/HIV co-infection are IL-1a, IL-1Ra, IL-8, CXCL9, CXCL10, IL-10, and IL-7.