Dynamic Analysis Of Th17 Cytokines And Their Relationship With Oral Candidiasis Among HIV/AIDS Patients During The First Year Of Highly Active Anti-Retrovial Therapy

Objectives:To investigate the reason why HIV patients are susceptible to oral candidiasis (OC) and to get the information of oral candidiasis -specific immunity.Method:This study included 25 HIV-infected patients recruited from Guangxi Center for Disease Control (CDC) and 25 healthy volunteers as healthy controls (HC). After baseline (0) examination, the patients were followed up in the consecutive 3rd,6th and 12th month. On each visit, oral manifestations were examined and recorded; samples of oral rinses were collected for culture of Candida and blood samples were taken for detecting cytokines (IL-4, IL-17(A/F), IFN-γ, IL-6, IL-23) and HBD2 level. Cytokines levels were detected by multiplexed microsphere-based flow cytometric assays and HBD2 level was detected by ELISA.In SPSS Version 16.0, the change trend of oral Candida load, CD4+T cell count, viral load, cytokines and HBD2 at baseline 3, 6 and 12 months was analyzed by Mann-Whitney U test or Friedman test. The correlation between oral Candida load, CD4+T cell count, viral load, cytokines and HBD2 were assessed by Pearson, Spearman rank correlation or logistic regression analysis.Results:HIV/AIDS patients had lower level of IFN-γ, IL-17(A/F) and higher level of IL-4, IL-6, HBD2 and no significant difference of IL-23 level compared to those of the healthy control. During the 1st year HAART there was an uptrend change of the level of CD4+T cell count,IL-23, IL-17(A/F) and IFN-y; a downtrend change of the level of IL-4,oral Candida load and viral load.At baseline, the HIV-infected patient with OC had lower IL-17(A/F) level than the HIV patient without OC did. Meanwhile, the OC and CFU were only in negative relation to IL-17(A/F). At 3 month and 6 month, the OC and CFU were negatively related to IL-17(A/F) and IFN-y and positively related to IL-4.In healthy control, the oral CFU was only negatively related to IFN-γ.Conclusion:The Thl and Th17 cell-mediated immunity were impaired in HIV/AIDS patients. At this status, as a factor of innate immune, HBD2 played a compensation role. The IL-17(A/F) may play a pivotal role in the anti-oral candidiasis among HIV/AIDS patients. With the recovery of HIV/AIDS immune and in healthy control, the IFN-γ participated in the anti-oral candidiasis mechanism.The high level of IL-4 may increase the susceptibility of oral candidiasis.