Plasma concentrations of IP-10 and MCP-1 as predictors of immunological non-response in people living with HIV receiving antiretroviral therapy.

INTRODUCTION

To identify plasma cytokine biomarkers predictive of immunological non-response in people living with HIV (PLHIV) undergoing long-term antiretroviral therapy (ART).

METHODS

PLHIV on ART with sustained HIV RNA < 50 copies/mL were enrolled at Guangzhou Eighth People's Hospital and followed for 4 years. Participants were classified as immunological responders (IR) or immunological non-responders (INR) after 4 years of ART, and stratified by baseline CD4+ T cell count (≤200 vs >200 cells/µL). Plasma concentrations of 14 cytokines were measured at baseline and 2 years using a multiplex bead-based immunoassay. Receiver operating characteristic analyses were used to assess predictive value.

RESULTS

Among 136 participants, 71 were IR and 65 were INR. Lower baseline CD4+ T cell counts correlated with elevated cytokine levels, which declined over time irrespective of immune outcome. Baseline IP-10, MCP-2, and Granzyme B levels correlated positively with 4-year CD4+ T cell recovery. IP-10 was significantly higher in IR than INR among PLHIV with baseline CD4+ T cell count ≤200 cells/µL, whereas MCP-1 was elevated in INR in the >200 cells/µL subgroup. Combining IP-10 or MCP-1 with baseline CD4+ T cell counts improved INR prediction compared to CD4+ T cell count alone.

CONCLUSION

IP-10 and MCP-1 demonstrated strong predictive value for INR in PLHIV with low and high baseline CD4+ T cell counts, respectively. These cytokines may serve as valuable biomarkers for guiding individualized immune monitoring in ART-treated PLHIV.