Title : IFN-γ's discriminatory performance to predict antimalarial and antityphoidal treatment outcome and recovery rate
Abstract:
Background: Although antimalarial and antityphoidal therapies are clinically effective, they can profoundly influence host immune responses, which may in turn affect recovery rates. Identifying reliable immune biomarkers that predict treatment outcomes is crucial for improving patient management. This study focused on the discriminatory capacity of interferon-gamma compared with other cytokines in predicting clinical outcomes and recovery rates in malaria, typhoid, and co-infected patients.
Methods: A prospective observational cohort study was conducted at Obala District Hospital, Yaoundé, Cameroon. Cytokine concentrations were measured in patients receiving standard antimalarial and/or antityphoidal therapy and compared with healthy controls. A panel of pro-inflammatory (IL-1β, IL-2, IL-6, TNF-α, IFN-γ) and anti-inflammatory (IL-10, IL-4) cytokines was quantified using ELISA. Exploratory analyses were performed in GraphPad Prism, while correlation and ROC analyses (SPSS, 95% CI, p < 0.05) were used to assess relationships between cytokine profiles, treatment outcomes (“resolved” vs. “unresolved”), and recovery times.
Results: By day 5 (±2), the overall recovery rate was 52.7%, with malaria patients recovering faster (65.0%) than typhoid patients (35.0%). Antimalarial therapy significantly increased IL-2 and IL-1β, whereas antibiotics upregulated IL-1β, IL-2, and TNF-α. Combination therapy reduced IL-10 and IFN-γ but increased TNF-α. Recovery time positively correlated with elevated pro-inflammatory cytokines, while higher IL-10 levels were linked to faster recovery in typhoid patients. ROC analysis demonstrated IFN-γ’s outstanding discriminatory performance in malaria (AUC = 0.936), and in co-infected patients, IFN-γ, IL-2, and IL-6 all showed strong predictive capacity (AUC > 0.93).
Conclusion: Antimalarial and antityphoidal therapies dynamically modulate immune responses. Among the cytokines assessed, IFN-γ emerged as the most powerful predictor of treatment outcome and recovery, highlighting its potential role as a biomarker for guiding therapeutic strategies in malaria, typhoid, and co-infections.
