The Levels Of Endotoxin,TNF-α And IL-6 In Serum In HIV-infected Patients With Opportunistic Infection

Background and objectiveHuman immunodeficiency virus (HIV) can invade the CD4+ lymphocytes after the humen was infected by Human immunodeficiency virus, This will cause immunodeficiency . Because of immunodeficiency , HIV-infected patients were easily infected by bacteria, virus and so on. HIV-infected patients' Opportunistic infections (OI) were complex and variable, It was difficult to diagnose and treat. Opportunistic infections has became the main reason that leaded to the HIV-infected patients' deaths. How to predict and treat the HIV-infected patients' Opportunistic infections is more important to improve the HIV-infected patients' lives.HIV-infected patients were often infected by bacteria and fungus. It is specially commonly seen in our country . Diagnosing and treating these HIV-infected patients who were infected by bacteria and fungus could evidently improve their lives. Endotoxin was lipopolysaccharide (LPS) that was existed in Gram-negative bacteria' walls. It was founded in many bacteria and funguses. Endotoxin had inseparable correlations with these opportunistic infections that was caused by bacteria and fungus. Measuring the endotoxin levels in serum can know opportunistic infections' conditions immediately, it is beneficial to diagnose and treat opportunistic infections earlier. Tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were all inflammation factors. It is indicated that They played important roles in the inflammation that was caused by enditoxia in the human body, Endotoxin, TNF-αand IL-6 effected and connected each other in endotoxia. But in clinic we founded that their mechanisms were very complicated. More and more began to study How to predict and treat endotoxia in these recent years. In this study, we measured the levels of endotoxin, TNF-αand IL-6 in serum of HIV-infected patients so as to explore their changes and correlations in HIV-infected patients with opportunistic infections.Materials and Methods(1) Serum were respectively aspirated from 18 HIV-infected patients with opportunistic infections and 23 HIV-infected patients without clinic symptom . 20 controls were aspirated from adults who were healthy. (2) Put 0.5 ml blood into 0.5 ml 10% heparin, 1000/r centrifugalizing to get the serum and preserve it in -20°C refrigerator to measure endotoxin levels. Put 0.2 ml blood into 0.2 ml 10% heparin , use the same way to measure the levels of TNF-αand IL-6. (3) Endotoxin levels were measured by using chismogenic limulus amebocyte lysate test (LAC). TNF-αand IL-6 with enzyme linked immuno sorbent assay (ELISA). (4) Statistical assay: the date were dealt with SPSS10.0 Statistical software by analysis of rariance and linear correlations.Results(1) The levels of endotoxin in serum: the levels of endotoxin in HIV-infected patients with opportunistic infections were(0.2701±0.056)EU/ml ,in HIV-infected patients without clinic symptoms were(0.0771±0.039)EU/ml, in controls were (0.0473±0.021)EU/ml ; There was significant difference between HIV-infected patients with opportunistic infections and controls (p<0.01). There was significant difference between HIV-infected patients without clinic symptoms and controls (p< 0.01). There was significant difference between HIV-infected patients with opportunistic infections and HIV-infected patients without clinic symptoms (p<0.01). 2. The levels of TNF-αin serum: the levels of TNF-αin HIV-infected patients with opportunistic infections were (1138.1±115.6) ng/L, in HIV-infected patients without clinic symptoms were (357.5±59.6) ng/L, in controls were (184.3±52.8) ng/L; there was significant difference between HIV-infected patients with opportunistic infections and controls(p<0.01). There was significant difference between HIV-infected patients without clinic symptoms and controls(p<0.05) There was significant difference between HIV-infected patients with opportunistic infections and HIV-infected patients without clinic symptoms p<0.01). 3. The levels of IL-6 in serum: the levels of IL-6 in HIV-infected patients with opportunistic infections were (1787.7±170.4) ng/L, in HIV-infected patients without clinic symptoms were (338.7±42.6) ng/L, in controls were (134.7±64.5) ng/L; there was significant difference between HIV-infected patients with opportunistic infections and controls (p <0.01). There was significant difference between HIV-infected patients without clinic symptoms and controls(p<0.01). There was significant difference between HIV-infected patients with opportunistic infections and HIV-infected patients without clinic symptoms(p<0.01). 4. The levels of endotoxin, TNF-αand IL-6 in serum in HIV-infected patients with opportunistic infections in infection without treatment and infection with treatment: the levels of endotoxin in infection without treatment were (0.2701±0.056) EU/ml, in infection with treatment were (0.1347±0.026) EU/ml; the levels of TNF-αin infection without treatment were (1138.1±115.6) ng/L, in infection with treatment were (576.9.5±86.2) ng/L; the levels of IL-6 in infection without treatment were (1787.7±170.4)=ng/L, in infection with treatment were (673.5±93.3) ng/L; There was significant difference between opportunistic infections without treatment and infections with treatment about three items (P<0.001. 5.Correlation among endotoxin , TNF-αand IL-6 in HIV-infected patients with opportunistic infections: there are positive correlation between endotoxin and TNF-α. IL-6 (r=0.76,p<0.01; r=0.64,p<0.01), The same to TNF-αand IL-6 (r=0.75, p<0.01). In two other groups they have no correlation.Conclusions(1) The levels of endotoxin, TNF-αand IL-6 in HIV-infected patients are higher than those of healthy, especially in patients HIV-infected with opportunistic infections. The higher the levels of endotoxin, TNF-αand IL-6, The seriouser the HIV-infected patients' conditions are. (2) There are positive correlation between endotoxin and TNF-α, the same to endotoxin and IL-6, TNF-αand IL-6.they effect and connect each other in disease. (3) Endotoxin, TNF-αand IL-6 have inseparable correlations with opportunistic infections and HIV-infected patients without clinic symptoms. Detecting their expressions in HIV-infected patients regularly is benifical to predict opportunistic-infection and diagnose and treat it earlier.