Cytokine biomarkers and their relationship to symptoms and quality of life in people with HIV ‐associated Kaposi sarcoma

Introduction Quality of life (QOL) is an essential component of care in people with HIV‐associated Kaposi sarcoma (HIV‐KS). Kaposi sarcoma herpes virus (KSHV) promotes cytokine expression and a dysfunctional inflammatory environment, contributing to KS pathogenesis and progression. However, disease‐related inflammatory factors influencing QOL and symptoms remain underexplored. This study examines the relationship between baseline QOL parameters and inflammatory cytokine biomarkers in treatment‐naïve Africans with HIV‐KS participating in the randomized controlled KAART study. We hypothesized that inflammatory cytokines are linked with reduced QOL and symptom burden. Methods Twenty‐eight cytokines were measured from stored baseline serum using the Milliplex® multiplex assay. QOL was assessed using the validated EORTC QLQ‐C30. Spearman Rho‐Rank correlation was used to assess relationships between cytokine levels and QOL parameters, with p ≤ 0.01 considered statistically significant. Results Paired cytokine and QOL data were available for 68 participants. IL‐8 showed significant negative correlations with summary scores, a reliable indicator of overall QOL ( r s = −0.35, p = 0.005). Increased IL‐8 also correlated significantly with reduced emotional functioning scales ( r s = −0.33, p = 0.01) and increased pain ( r s = 0.32, p = 0.01). By contrast, increased IL‐10 correlated significantly with reduced pain ( r s = −0.31, p = 0.01). VEGF and MCP‐1 levels correlated negatively with role functioning ( r s = −0.32, p = 0.01; r s = −0.30, p = 0.01). Conclusion IL‐8 is a key cytokine affecting QOL in HIV‐KS. Elevations have a negative impact on pain, emotional functioning and overall QOL. IL‐10, VEGF and MCP‐1 perturbations also impact QOL. These findings enhance understanding of cytokine involvement in KS pathogenesis.