Инфекция и иммунитет (Sep 2018)
DYNAMICS OF IL-2 PLASMA LEVELS IN HIV PATIENTS WITH CONSIDERING DRUGS RESISTANCE
Abstract
Interleukin-2 (IL-2) is one of the most important cytokines involved in the regulation of innate and adaptive immunity. Its main immunological function is to regulate a specific (antigen-dependent) immune response by stimulating proliferation and differentiation of immune cells involved in its realization, including Т-lymphocytes. Dysfunction of cellular immunity is the main pathogenetic mechanism for the development of HIV infection.Objective: to identify patterns of IL-2 levels change in HIV-infected patients on the background of drug resistance at the later stages of infection. The study included 83 patients with HIV infection receiving highly active antiretroviral therapy; the control group consisted of 20 healthy blood donors. All patients underwent a study of the effectiveness of antiretroviral therapy, including an assessment of HIV viral load and CD4+ Т lymphocyte levels. In patients with ineffective antiretroviral therapy, a study of drug resistance to HIV by Senger sequencing was additionally conducted. According to the results of genome sequencing, HIV-infected patients with ineffective antiretroviral therapy were divided into two subgroups — with revealed drug resistance (58.5%) and absence of detectable resistance mutations in the genome (41.5%). Levels of IL-2 were measured in all persons included in the study by the method of enzyme immunoassay. When comparing the levels of IL-2 between groups of patients with continuing viral load on the background of antiretroviral therapy (viral load is detected) with drug resistance and without it, significant differences were obtained (1.75±0.26 pg/ml versus 1.95±0.29 pg/ml, p ≤ 0.05, U-criterion, respectively). The content of IL-2 is statistically significantly lower in the group of patients who did not succeed with antiretroviral therapy than in the group of patients with treatment efficacy (1.83±0.29 pg/ml versus 4.89±0.55 pg/ml, respectively, p < 0.001, U-criterion). Thus, it is shown that in patients with revealed drug resistance against the background of progression of HIV infection there is a decrease in levels of IL-2. The increase in its levels in patients with HIV infection who have reached virological and immunological success of therapy is due to the reduction in the number of the cytokine-producing immune cells (T-lymphocytes). We assume that a significant decrease in the levels of IL-2 makes an additional contribution to the disruption of the processes of proliferation and differentiation of immunocompetent cells in HIV infection, which is of great importance in the formation of drug resistance of HIV in conditions of constant viral replication.
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