Marcadores sorológicos do HIV: avaliação e prognóstico do imunocomprometido

Abstract

The Human Immunodeficiency Virus (HIV) is the causative agent of acquired immunodeficiency syndrome (AIDS), a disease characterized by chronic immunosuppression. According to the Ministry of Health, the clinical course of the disease can be divided into three distinct phases: acute, chronic, and AIDS and the critical phase proceeded by a long asymptomatic phase. The laboratory diagnosis is performed by detecting antibodies againtHIV and the presence of specific antibodies against the fractionated proteins of the virus. Since its discovery in the beginning of 80s monitoring of HIV positive patients has been accomplished by measuring viral load and quantification of CD4+T lymphocytes. The evaluation immunocompromised throughout the clinical course of HIV disease has revealed that virus not only promotes the destruction of CD4+ but also causes an exacerbated in imbalance inflammatory cytokines and activation of the immune system. Thus, the detection of serum markers of activation of the immune response as βeta-2-microglobulin (β 2-m), neopterin and soluble receptor activator of plasminogen (Supar) can store large correlation with disease progression, since elevated levels of these markers were found in patients in the symptomatic phase. The HIV by mechanisms not yet elucidated reduces the concentration of viral suppressors like type I interferons (IFN-α and IFN-β), and interleukin-10 (IL-10) and promotes viral inducers like IL-6, IL-15, IL -1 and tumor necrosis factor-alpha (TNF-α) thus contributing to the establishment of AIDS. Elevated levels of interleukin-6 and interleukin -10 were found in terminally ill patients and might considered important serum markers of prognosis. Although these markers have been reported in a large number of studies, it is still necessary to conduct more research to prove the effectiveness of these substances as indicators of the clinical condition of the immunocompromised. In addition, they must be performed to validate analytical methods and the establishment of benchmarks.