RESEARCHERS have identified key immunological markers associated with mortality in hospitalised people living with HIV/AIDS (PLWHA), highlighting the impact of delayed treatment and poor adherence to antiretroviral therapy (ART).
Researchers conducted a longitudinal observational study at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado in Manaus, Brazil, enrolling 111 participants between 2018–2019. Clinical and laboratory data were extracted from electronic medical records, and plasma samples were analysed for 27 cytokines and chemokines using the Luminex® multiplex assay. Samples were collected within 72 hours of admission and again 6 hours post-mortem to assess inflammatory responses and immune activation levels.
Results showed that ART-naïve PLWHA had a significantly higher risk of death than those who were ART-non-adherent. The majority of the 27 immunological markers measured were elevated in deceased patients compared to those who survived. Increased levels of IFNγ, CCL2, and CCL3 were particularly associated with mortality. ART-naïve individuals exhibited a strong correlation between high cytokine levels and low CD4 counts, with IL-17 significantly elevated in this group, whereas IL-2 was higher in ART-non-adherent patients. A distinct T helper-2 response was observed, with IL-9 predominating in ART-naïve cases and IL-5 in ART-non-adherent individuals.
These findings emphasise the heightened mortality risk in ART-naïve hospitalised PLWHA and suggest that specific cytokines may serve as predictors of death. The immune response differences between ART-naïve and ART-non-adherent patients point to the urgent need for improved early diagnosis and ART adherence interventions.
Ada Enesco, EMJ
Reference
Chaves YO et al. Association between cytokine and increased risk of death in ART- naïve and ART-non-adherence patients hospitalized with advanced HIV disease. BMC Infect Dis. 2025;25(1):197.
