Perfil sérico de citocinas Th1, Th2 e Th17 em pacientes coinfectados por L.infantum/HIV no Estado do Maranhão, Brasil

Abstract

Visceral Leishmaniasis (LV) and HIV / AIDS are serious public health problems in the state of Maranhão, considering the isolated analysis of these diseases, as well as the cases of patients co-infected with Leishmania infantum and HIV. Several evidences have demonstrated that the pathogens of both diseases seem to interact synergistically, leading to a worsening of the clinical manifestations in patients. This can be explained by the parasite-host interaction, considering the virulence profile of the pathogens, as well as some specific components of the host, in particular the immunological aspects, reflected in the innate and adaptive immune response. Thus, the objective of thisstudy was to evaluate the production profile of inflammatory cytokines in Leishmaniasis / HIV co-infection in the state of Maranhão - Brazil. The research is a descriptive study of the comparative-transversal type carried out with 25 individuals with visceral leishmaniasis and 25 co-infected LV / HIV individuals, attended at the State reference Hospital for infectious and parasitic diseases in São Luís (MA). From these patients, epidemiological information was obtained, as well as serological collection was performed to assess the production of inflammatory cytokines, detected by flow cytometry. From an epidemiological point of view, male individuals represented 84% of co-infected patients and 96% of non-co-infected patients; lethality and clinical recurrences were significantly higher in co-infected patients, 13.5% and 73.0%, respectively. As for the immunological aspects related to inflammatory cytokines, only the production of IL-10 was statistically higher in the group of co-infected patients, but there was no difference in the total production of cytokines within this group when considering patients with or without recurrences. The combined analysis showed that there were significant positive correlations within the group of co-infected patients, when comparing two cytokines simultaneously. This result demonstrates the interaction that occurs in the production of these cytokines, especially in the group of co-infected patients, indicating that multiple analyses are necessary to understand the profile of the production of inflammatory cytokines in these patients. Demonstrating the role of inflammatory cytokines in the pathogenesis of these diseases can be important to optimize treatments and consequently reduce their lethality.