Table 4 Comparison of Th1 and Th2 cytokines between culture negative AFB microscopy smear negative and culture positive AFB smear negative participants stratified by CD4 and CD8 levels.

From: The diagnostic accuracy of Th1 (IFN-γ, TNF-α, and IL-2) and Th2 (IL-4, IL-6 and IL-10) cytokines response in AFB microscopy smear negative PTB- HIV co-infected patients

Strata

Cytokines (pg/mL)

Culture negative AFB microscopy smear negative

Culture Positive AFB microscopy smear negative

P-value

Median (IQR)

CD4 ≤ 200

Th1 cytokines

N = 34

N = 11

 

IFN-γ

6.8 (5.6, 17.8)

23.6 (7.6, 92.8)

0.062

TNF-α

17.1 (14.8, 19.7)

15.2 (15.0, 18.7)

0.579

IL-2

15.9 (7.1, 25.7)

31.2 (5.0, 56.6)

0.362

IL-8

127.5 (47.1, 202.5)₮

119.4 (112.7, 149.0)§

0.756

IL-12p70

2.5 (1.4, 3.6)₮

1.3 (0.6, 3.2)§

0.460

CD4 > 200

 

N = 12

N = 13

 

IFN-γ

11.2 (6.4, 15.4)

164.0 (38.8, 240.8)

0.002

TNF-α

14.8 (13.5, 16.5)

22.2 (18.9, 28.3)

<0.001

IL-2

13.7 (10.7, 37.3)

80.9 (24.9, 153.3)

0.015

IL-8

197.8 (144.0, 204.9)

135.2 (21.3, 168.4)

0.077

IL-12p70

1.2 (0.5, 1.9)

3.8 (2.3, 5.0)

0.001

CD4 ≤ 200

Th2 cytokines

N = 34

N = 11

 

IL-4

10.7 (3.2, 28.7)

4.1 (1.8, 54.0)

0.663

IL-6

14.9 (6.1, 52.4)

10.9 (6.4, 35.4)

0.579

IL-10

13.4 (10.0, 19.8)

8.1 (7.0, 13.7)

0.027

CD4 > 200

 

N = 12

N = 13

 

IL-4

1.8 (0.0, 13.0)

54.3 (22.6, 71.2)

0.001

IL-6

7.5 (3.1, 11.9)

16.9 (7.7, 42.1)

0.092

IL-10

8.1 (7.6. 10.5)

11.6 (8.7, 13.3)

0.276

CD8 ≤ 1000

Th1 cytokines

N = 31

N = 19

 

IFN-γ

8.4 (5.0, 26.4)

52.0 (16.2, 170.0)

0.001

TNF-α

16.5 (14.6, 18.5)

21.4 (16.2, 25.5)

0.002

IL-2

12.3 (6.2, 25.1)

50.5 (19.8, 77.9)

0.003

IL-8

154.0 (50.6, 206.1)†

119.4 (72.5, 151.5)ħ

0.406

IL-12p70

1.9 (0.7, 3.4)†

2.3 (1.2, 5.6)ħ

0.161

CD8 > 1000

 

N = 15

N = 5

 

IFN-γ

6.8 (6.0, 11.2)

200.8 (5.2, 240.8)

0.457

TNF-α

14.8 (14.2, 19.7)

18.1 (14.0, 18.2)

0.896

IL-2

16.6 (11.5, 28.9)

157.3 (0.5, 158.8)

0.541

IL-8

194.7 (39.9, 202.4)

164.9 (111.1, 168.4)

0.727

IL-12p70

2.3 (1.1, 3.3)

3.4 (3.4, 3.8)

0.088

CD8 ≤ 1000

Th2 cytokines

N = 31

N = 19

 

IL-4

8.4 (0.2, 21.0)

38.4 (8.1, 57.4)

0.026

IL-6

8.7(2.8, 19.3)

9.2 (5.5, 52.5)

0.401

IL-10

12.7 (8.4, 20.7)

11.6 (7.1, 15.3)

0.159

CD8 > 1000

 

N = 15

N = 5

 

IL-4

8.9 (1.8, 27.9)

54.3 (2.6, 55.9)

0.221

IL-6

22.0 (8.3, 50.1)

15.6 (14.9, 16.9)

0.861

IL-10

10.4 (8.2, 14.9)

8.7 (7.2, 10.7)

0.238

  1. ₮N = 32; §N = 10; †N = 29; ħN = 18, p-value < 0.0127 (Bonferroni corrected P-value for multiple comparisons).
  2. When we further stratified the study participants into those with CD4 ≤ 200 and CD4 > 200 and compared to culture-negative AFB microscopy smear negative and culture-positive AFB microscopy smear negative. There was no significant difference in levels of Th1 cytokines (IFN-γ, TNF-α, IL-2, IL-8 and IL-12p70) and Th2 cytokines (IL-4, IL-6 and IL-10) in study participants with CD4 ≤ 200.
  3. However, in the study participants with CD4 > 200, there was significant difference in Th1 cytokines between culture-negative AFB microscopy smear negative and culture-positive AFB microscopy smear negative, IFN-γ (P = 0.002), TNF-α (P < 0.001), IL-2 (P = 0.015), and IL-12p70, P = 0.001). Only IL-4 median levels were significantly different (P = 0.001) between culture-negative AFB microscopy smear negative and culture-positive AFB microscopy smear negative among the study participants with CD4 > 200.
  4. We further stratified the study participants into those with CD8 ≤ 1000 and CD8 > 1000 and compared to PTB culture-negative and -positive AFB microscopy smear negative. Among study participants who had CD8 ≤ 1000, IFN-γ (P = 0.001), TNF-α (P = 0.002), IL-2 (P = 0.003), and IL-4 (P = 0.026) were significantly different between culture-negative AFB microscopy smear negative and culture-positive AFB microscopy smear negative. While in study participants with CD8 > 1000, there was no difference in Th1 and Th2 cytokines levels evaluated between PTB culture-negative and -positive AFB microscopy smear negative.
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