Cytokine profiles and CD4 counts in HIV-positive individuals with cysticercosis: Implications for sex-specific immune responses in co-endemic regions of Tanzania

Yakobo Leonard Lema ^1* Ulrich Fabien Prodjinotho ^2,3 Charles Makasi ^1,4 Mary-Winnie A Nanyaro ¹ Andrew Martin Kilale ¹ SAYOKI GODFREY MFINANGA ^1,5,6 Veronika Schmidt ³ Hélène Carabin ^10,7,8,9 Andrea Sylvia Winkler ^11,12,3 Eligius F Lyamuya ¹³ Bernard James Ngowi ^1,14 Clarissa Prazeres da Costa ^15,2,3* Charlotte Rüther ¹⁶

• ¹ Muhimbili Medical Research Center, National Institute for Medical Research (NIMR), Dar Es Salaam, Tanzania
• ² Institute for Microbiology, Immunology and Hygiene, University Hospital rechts der Isar, Technical University of Munich, Munich, Bavaria, Germany
• ³ Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
• ⁴ Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
• ⁵ Kampla International University Tanzania Campus, Dar Es Salaam, Tanzania
• ⁶ School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
• ⁷ Department of Veterinary Biomedicine, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
• ⁸ School of Public Health, University of Montreal, Montreal, Canada
• ⁹ Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Saint-Hyacinthe, Quebec, Canada
• ¹⁰ Public Health Research Center of the University of Montreal and the CIUSSS of Center-Sud-de-l'île-de-Montréal (CReSP),, Montreal, Canada
• ¹¹ Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
• ¹² Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States
• ¹³ Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
• ¹⁴ Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Dar es Salaam, Dar es Salaam, Tanzania
• ¹⁵ German Center for Infection Research (DZIF), Partner site Munich, Braunschweig, Bavaria, Germany
• ¹⁶ Department of Radiology, University Hospital TUM, Technical University Munich (TUM), Munich, Germany

The interplay between HIV and Taenia solium cysticercosis in co-endemic regions remains poorly understood, particularly regarding the immune responses but is relevant for an effective treatment strategy. This study aimed to investigate the relationship between peripheral cytokine profiles, CD4 + T-cell counts, and cysticercosis infection status in HIV-positive individuals in Tanzania's southern highlands.We conducted a cross-sectional study involving 110 HIV-positive individuals.Cysticercosis was diagnosed using antibody and antigen tests, with neurocysticercosis confirmed by CT imaging. CD4 counts and serum cytokine levels (pro-and anti-inflammatory) were analyzed using multivariate regression and MANOVA, including sex-stratified analyses.Results: Among participants, 20.9% tested positive for cysticercosis antibodies, 43.6% for antigens and 20.2% presented with brain cysts, with 10.6% showing active neurocysticercosis.Cysticercosis-positive individuals showed positive correlations between CD4 counts and proinflammatory cytokines (e.g., TNF-α, IL-1β), contrasting with negative correlations in cysticercosis-negative individuals. Sex-stratified analysis showed stronger regulatory cytokine responses in males compared to females, particularly involving higher levels of IL-10 and IL-4 indicating sex-specific immune modulation in co-infected individuals. However, overall cytokine profiles were not significantly influenced by CD4 categories or cysticercosis status.These results contribute to our understanding of immunological interactions in HIVcysticercosis co-infection and underscore the need for further research with larger sample sizes to elucidate the clinical implications of these findings. Such studies could inform the development of more effective, sex-personalized treatment strategies for HIV patients in cysticercosis-endemic regions.