Evaluation of Serum Interleukin 6, Tumor Necrosis Factor-Alpha, and Interferon-Gamma Levels in Relation to Body Mass Index and Blood Pressure in HIV Seropositive Pregnant Women Coinfected with Malaria

Abstract

Malaria and HIV are leading causes of morbidity and mortality, particularly in sub-Saharan Africa. Both diseases are highly endemic and have a wide geographic overlap with severe impact on pregnancy. This was a case-control study designed to evaluate the levels of interleukin -6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) and their relationship with some anthropometric indices such as body mass index (BMI) and blood pressure in HIV-malaria coinfected women attending antenatal clinic at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria. 122 pregnant women and 30 nonpregnant women (control) aged between 18 and 42 years were recruited for the study. Screening of HIV antibodies was done using a national algorithm. Peripheral malaria was determined using rapid detection and the Giemsa stain technique. Cytokines were assayed using the enzyme-linked immunosorbent assay technique. HIV-malaria coinfected pregnant women showed significantly higher levels of IL-6, IFN-γ, TNF-α, and blood pressure with reduced BMI value compared with HIV seronegative pregnant and nonpregnant control participants ( p ≤ 0.001 , respectively). The findings indicated significant cytokine imbalance which suggests an active inflammatory process and reduced cellular immunity. The increased BMI and blood pressure level observed indicate overweight and possible hypertension which could subsequently lead to preeclampsia and other adverse pregnancy outcomes.

Assessment of serum soluble intercellular adhesion molecule-1 and albumin in human immuno-deficiency virus-infected individuals with or without malaria parasite infection in Nauth, Nnewi, Nigeria

“…44 This is further worsened by co-morbidity with HIV infection causing disease progression and severity. 45 A more longitudinal study is needed to explain the consequences of these variations in blood pressure in HIV-infected individuals especially in endemic regions of co-infections.…”

Malaria and HIV Co-Infection among Pregnant Women in Africa: Prevalence, Effect on Immunity and Clinical Management: Review

“…Regardless of their malaria status, HIV-infected women's IVBMCs generate considerably lower amounts of IFN-γ than HIV-uninfected women, particularly in response to stimulation with crude blood-stage malaria antigens [74]. Other studies showed that IL-12, which contributes to IFN-γ regulation, was impaired to almost undetectable levels in IVBMC among HIV-infected pregnant women [73,78]. However, some studies have shown an increased level of IL-10 amongst HIV-infected pregnant women and a low likelihood of flora infection [79].…”