Immunological aspects of kidney damage in HIV infection

Abstract

The aim of the study was to assess the role of cellular and cytokine components of the immune response in kidney disease in patients with HIV infection.

Material and methods. The study included 40 patients with HIV infection, who were determined by indicators of cellular immune response and cytokine status. Among them are 30 HIV-infected patients with chronic kidney disease, 10 patients with HIV infection without renal pathology. Control group - 24 healthy people were selected to analyze the immune status and 15 people to assess the normal cytokine profile. The study of the cell composition of lymphocytes of a typical immunogram was performed on a flow cytofluorimeter BD FACSCanto II. Determination of serum cytokine concentration was carried out by the method of solid-phase ELISA on a multichannel photometer Infinite F50.

Results and discussion. In patients with HIV infection, taking into account the presence and absence of proteinuria, kidney damage developed against the background of a more pronounced drop in the blood T-helper subpopulation of lymphocytes (0.2x109/L and 0.4x109/L, respectively, p=0.015) with a predominance of pro-inflammatory and immunosuppressive reactions. With a decrease in the level of CD4+-lymphocytes <200 cells/pl and an increase in the concentration of HIV RNA in the blood >100,000 copies/ml in HIV-infected patients with kidney damage, an increase of more than 50 times in the profibrotic cytokine TGFβ, which plays an important role in the progression of renal damage, was noted, and a statistically significant increase in TNFα. In the development of kidney damage in HIV infection, the leading role of TNFα has been established in combination with high viral load and depression of the immune system.

Keywords:HIV-infection, kidney, immunopathogenesis, markers of kidney damage, proteinuria, cytokines

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Yushchuk N.D., Gadzhikulieva M.M., Volgina G.V., Balmasova I.P., Gultyaev M.M. Immunological aspects of kidney damage in HIV infection. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2020; 9 (1): 36-42. doi: 10.33029/2305-3496-2020-9-1-36-42 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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