Exploring the potential of IP-10 and sCD14 as inflammatory biomarkers in HIV–TB co-infection: a systematic review

Human Immunodeficiency Virus (HIV) and tuberculosis (TB) are major global health challenges, especially in sub-Saharan Africa and Southeast Asia, where their co-infection greatly increases illness and death. People living with HIV are far more likely to develop TB, and the interaction between the two infections worsens immune dysfunction and complicates management. This systematic review followed PRISMA 2020 guidelines to assess the roles of Interferon-γ–induced Protein 10 (IP-10) and Soluble Cluster of Differentiation 14 (sCD14) as inflammatory biomarkers in HIV-TB co-infection. A comprehensive search of PubMed, Scopus, and Google Scholar was conducted for studies published between 2014 and 2024. Eligible interventional and observational studies involving adults with HIV-TB co-infection were included based on predefined inclusion criteria. Data extraction covered study characteristics, biomarker levels, and their associations with inflammation, disease progression, and clinical outcomes. Six studies met the inclusion criteria, all assessing IP-10, while only one measured sCD14. Most studies reported significantly elevated IP-10 levels in HIV–TB co-infected individuals, linking it to systemic inflammation, disease progression, and poor clinical outcomes, highlighting its potential as a predictive and prognostic biomarker. The single study evaluating sCD14 found increased levels indicating generalized immune activation but limited specificity for distinguishing Tuberculosis-Immune Reconstitution Inflammatory Syndrome , suggesting its broader role as a nonspecific marker of inflammation. Although the current evidence base is limited, IP-10 shows promise as a diagnostic and prognostic biomarker, and sCD14 may complement its use as a marker of immune activation. Further large-scale, standardized studies are needed to validate these biomarkers in HIV–TB co-infection.