Plasma IL-6 and IL-9 predict the failure of interferon-α plus ribavirin therapy in HIV/HCV-coinfected patients.

The cytokine profile plays an important role in treatment outcome of hepatitis C virus (HCV) infection, and probably modulates the immune response against HCV. The aim of this study was to evaluate which cytokines affect the response to interferon- (IFN-) and ribavirin therapy and how these cytokines change 72 weeks after starting anti-HCV therapy in HIV/HCV-coinfected patients. We carried out a retrospective follow-up study of 65 patients on anti-HCV therapy. A sustained virological response (SVR) was defined as an undetectable HCV viral load up to 24 weeks after the end of treatment. Cytokines were measured using a multiplex immunoassay kit. On starting anti-HCV therapy, non-responder (NR) patients had higher levels of interleukin (IL)-6, IL-9, IL-10 and tumour necrosis factor (TNF)- (P0.05), while IL-17A levels were increased in SVR patients (P0.058). However, only patients with high levels of IL-6 and IL-9 had decreased odds to achieve SVR (P0.05). Plasma levels of IL-6 and IL-9 had a high predictive value for SVR failure [area under the ROC curve (AUC) 0.839 (95 CI 0.7330.945) and AUC 0.769 (95 CI 0.6530.884)]. In addition, during anti-HCV therapy, IL-1 showed an increase in NR patients (P0.015) and IL-10 decreased in SVR patients (P0.049). After clearing HCV infection, low levels of TNF-, IL-6, IL-9, IL-10, IL-13 and IL-22 were found in SVR patients (P0.05), as well as IL-1, but only near statistical significance (P0.073). High plasma levels of IL-6 and IL-9 had a high predictive value for SVR failure. Furthermore, clearing of HCV infection was associated with low inflammatory and T helper (Th)2/Th9/Th22 cytokine levels.