Cytokine biomarkers and their relationship to symptoms and quality of life in people with HIV-associated Kaposi sarcoma.

INTRODUCTION

Quality of life (QOL) is an essential component of care in people with HIV-associated Kaposi sarcoma (HIV-KS). Kaposi sarcoma herpes virus (KSHV) promotes cytokine expression and a dysfunctional inflammatory environment, contributing to KS pathogenesis and progression. However, disease-related inflammatory factors influencing QOL and symptoms remain underexplored. This study examines the relationship between baseline QOL parameters and inflammatory cytokine biomarkers in treatment-naïve Africans with HIV-KS participating in the randomized controlled KAART study. We hypothesized that inflammatory cytokines are linked with reduced QOL and symptom burden.

METHODS

Twenty-eight cytokines were measured from stored baseline serum using the Milliplex® multiplex assay. QOL was assessed using the validated EORTC QLQ-C30. Spearman Rho-Rank correlation was used to assess relationships between cytokine levels and QOL parameters, with p ≤ 0.01 considered statistically significant.

RESULTS

Paired cytokine and QOL data were available for 68 participants. IL-8 showed significant negative correlations with summary scores, a reliable indicator of overall QOL (rs = -0.35, p = 0.005). Increased IL-8 also correlated significantly with reduced emotional functioning scales (rs = -0.33, p = 0.01) and increased pain (rs = 0.32, p = 0.01). By contrast, increased IL-10 correlated significantly with reduced pain (rs = -0.31, p = 0.01). VEGF and MCP-1 levels correlated negatively with role functioning (rs = -0.32, p = 0.01; rs = -0.30, p = 0.01).

CONCLUSION

IL-8 is a key cytokine affecting QOL in HIV-KS. Elevations have a negative impact on pain, emotional functioning and overall QOL. IL-10, VEGF and MCP-1 perturbations also impact QOL. These findings enhance understanding of cytokine involvement in KS pathogenesis.