Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: A case-control study
Document Type
Journal Article
Publication Date
2-15-2013
Journal
PLoS ONE
Volume
Volume 8, Issue 2
Inclusive Pages
Article number e56249
Keywords
Anti-HIV Agents--therapeutic use; Biological Markers--blood; HIV Infections--blood; HIV Infections--complications; Pneumonia; Bacterial--etiology
Abstract
Background
Despite advances in HIV treatment, bacterial pneumonia continues to cause considerable morbidity and mortality in patients with HIV infection. Studies of biomarker associations with bacterial pneumonia risk in treated HIV-infected patients do not currently exist.
Methods
We performed a nested, matched, case-control study among participants randomized to continuous combination antiretroviral therapy (cART) in the Strategies for Management of Antiretroviral Therapy trial. Patients who developed bacterial pneumonia (cases) and patients without bacterial pneumonia (controls) were matched 1:1 on clinical center, smoking status, age, and baseline cART use. Baseline levels of Club Cell Secretory Protein 16 (CC16), Surfactant Protein D (SP-D), C-reactive protein (hsCRP), interleukin-6 (IL-6), and d-dimer were compared between cases and controls.
Results
Cases (n = 72) and controls (n = 72) were 25.7% female, 51.4% black, 65.3% current smokers, 9.7% diabetic, 36.1% co-infected with Hepatitis B/C, and 75.0% were on cART at baseline. Median (IQR) age was 45 (41, 51) years with CD4+ count of 553 (436, 690) cells/mm3. Baseline CC16 and SP-D were similar between cases and controls, but hsCRP was significantly higher in cases than controls (2.94 µg/mL in cases vs. 1.93 µg/mL in controls; p = 0.02). IL-6 and d-dimer levels were also higher in cases compared to controls, though differences were not statistically significant (p-value 0.06 and 0.10, respectively).
Conclusions
In patients with cART-treated HIV infection, higher levels of systemic inflammatory markers were associated with increased bacterial pneumonia risk, while two pulmonary-specific inflammatory biomarkers, CC16 and SP-D, were not associated with bacterial pneumonia risk.
Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.
APA Citation
Bjerk, S. M., Baker, J. V., Emery, S., Neuhaus, J., Angus, B., Gordin, F. M., Pett, S.L., Stephan, C., Kunisaki, K. M. (2013). Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: A case-control study. PLoS ONE, 8(2)
Peer Reviewed
1
Open Access
1
Comments
Reproduced with permission of PLoS ONE