HIV infection is associated with elevated biomarkers of immune activation in Ugandan adults with pneumonia.

Abstract

INTRODUCTION:

Pneumonia is an important cause of morbidity and mortality in persons living with human immunodeficiency virus (HIV) infection. How immune activation differs among HIV-infected and HIV-uninfected adults with pneumonia is unknown.

METHODS:

The Inflammation, Aging, Microbes, and Obstructive Lung Disease (I AM OLD) Cohort is a prospective cohort of adults with pneumonia in Uganda. In this cross-sectional analysis, plasma was collected at pneumonia presentation to measure the following 12 biomarkers: interleukin 6 (IL-6), soluble tumor necrosis factor receptors 1 and 2 (sTNFR-1 and sTNFR-2), high sensitivity C-reactive protein (hsCRP), fibrinogen, D-dimer, soluble CD27 (sCD27), interferon gamma-inducible protein 10 (IP-10), soluble CD14 (sCD14), soluble CD163 (sCD163), hyaluronan, and intestinal fatty acid binding protein. We asked whether biomarker levels differed between HIV-infected and HIV-uninfected participants, and whether higher levels of these biomarkers were associated with mortality.

RESULTS:

One hundred seventy-three participants were enrolled. Fifty-three percent were HIV-infected. Eight plasma biomarkers-sTNFR-1, sTNFR-2, hsCRP, D-dimer, sCD27, IP-10, sCD14, and hyaluronan-were higher among participants with HIV infection, after adjustment for pneumonia severity. Higher levels of 8 biomarkers-IL-6, sTNFR-1, sTNFR-2, hsCRP, IP-10, sCD14, sCD163, and hyaluronan-were associated with increased 2-month mortality.

CONCLUSIONS:

As in other clinical contexts, HIV infection is associated with a greater degree of immune activation among Ugandan adults with pneumonia. Some of these are also associated with short-term mortality. Further study is needed to explore whether these biomarkers might predict poor long-term outcomes-such as the development of obstructive lung disease-in patients with HIV who have recovered from pneumonia.

• Authors: Richard J Wang, Julia Moore, Daniela Moisi, Emily G Chang, Patrick Byanyima, Sylvia Kaswabuli, Emmanuel Musisi, Ingvar Sanyu, Abdulwahab Sessolo, Rejani Lalitha, William Worodria, J Lucian Davis, Kristina Crothers, Jue Lin, Michael M Lederman, Peter W Hunt, Laurence Huang
• Journal: PloS one (PLoS One) Vol. 14 Issue 5 Pg. e0216680 ( 2019) ISSN: 1932-6203 [Electronic] United States
• PMID: 31091258 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens, CD
• Biomarkers
• Fibrin Fibrinogen Degradation Products
• Interleukin-6
• Lipopolysaccharide Receptors
• Receptors, Tumor Necrosis Factor
• fibrin fragment D
• Hyaluronic Acid
• C-Reactive Protein

Topics

• Adult
• Antigens, CD (analysis, blood)
• Biomarkers (blood)
• C-Reactive Protein (analysis)
• Cohort Studies
• Cross-Sectional Studies
• Female
• Fibrin Fibrinogen Degradation Products (analysis)
• HIV Infections (complications, immunology, virology)
• Humans
• Hyaluronic Acid (analysis, blood)
• Inflammation (immunology)
• Interleukin-6 (analysis, blood)
• Lipopolysaccharide Receptors (blood)
• Male
• Middle Aged
• Monocytes (immunology)
• Pneumonia (complications, metabolism)
• Prospective Studies
• Receptors, Tumor Necrosis Factor (analysis, blood)
• Uganda (epidemiology)