Insights Into Circulating Cytokine Dynamics During Pregnancy in HIV-Infected Beninese Exposed to Plasmodium falciparum Malaria

• Published in: The American journal of tropical medicine and hygiene Vol. 93; no. 2; pp. 287 - 292
• Main Authors: Ibitokou, Samad A., Denoeud-Ndam, Lise, Ezinmegnon, Sèm, Ladékpo, Rodolphe, Zannou, Djimon-Marcel, Massougbodji, Achille, Girard, Pierre-Marie, Cot, Michel, Luty, Adrian J. F., Ndam, Nicaise Tuikue
• Format: Journal Article
• Language: English
• Published: United States The American Society of Tropical Medicine and Hygiene 01.08.2015
• Subjects: Adult; Antimalarials - therapeutic use; Benin - epidemiology; Drug Combinations; Female; HIV Infections - blood; HIV Infections - complications; Human immunodeficiency virus; Humans; Interleukin-10 - blood; Interleukin-2 - blood; Interleukin-4 - blood; Interleukin-5 - blood; Malaria, Falciparum - blood; Malaria, Falciparum - complications; Malaria, Falciparum - drug therapy; Plasmodium falciparum; Pregnancy; Pregnancy Complications, Infectious - blood; Pregnancy Complications, Infectious - virology; Pregnancy Complications, Parasitic - blood; Pregnancy Complications, Parasitic - drug therapy; Prospective Studies; Pyrimethamine - therapeutic use; Sulfadoxine - therapeutic use; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Tumor Necrosis Factor-alpha - blood; Young Adult; Benin
• ISSN: 0002-9637; 1476-1645; 1476-1645
• DOI: 10.4269/ajtmh.14-0653

We investigated the circulating plasma levels of Th1- (Interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α], interferon-gamma [IFN-γ]) and Th2-type (IL-4, IL-5, IL-10) cytokines in human immunodeficiency virus (HIV)-infected pregnant women living in a malaria-endemic area. We analyzed samples from 200 pregnant women included in the prevention of pregnancy-associated malaria in HIV-infected women: cotrimoxazole prophylaxis versus mefloquine (PACOME) clinical trial who were followed until delivery. Cytokine concentrations were measured by flow cytometry-based multiplex bead array. Significantly elevated levels of IL-10 and lower levels of TNF-α were observed at delivery compared with inclusion ( P = 0.005). At inclusion, the presence of circulating IFN-γ, a higher CD4 + T cell count and having initiated intermittent preventive treatment of malaria with sulfadoxine pyrimethamine (SP-IPTp) were all associated with a lower likelihood of Plasmodium falciparum infection. At delivery, the inverse relationship between the presence of infection and circulating IFN-γ persisted, although there was a positive association between the likelihood of infection and the presence of circulating TNF-α. Initiation of antiretroviral therapy was associated with elevated IL-5 production. Consistent with our own and others' observations in HIV seronegative subjects, this study shows circulating IL-10 to be a marker of infection with P. falciparum during pregnancy even in HIV-infected women, although plasma IFN-γ may be a marker of anti-malarial protection in such women.