Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: a case-control study

Bjerk, Sonja M., Baker, Jason V., Emery, Sean, Neuhaus, Jacqueline, Angus, Brian, Gordin, Fred M., Pett, Sarah L., Stephan, Christoph and Kunisaki, Ken M. (2013) Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: a case-control study. PLoS One, 8 2: . doi:10.1371/journal.pone.0056249


Author Bjerk, Sonja M.
Baker, Jason V.
Emery, Sean
Neuhaus, Jacqueline
Angus, Brian
Gordin, Fred M.
Pett, Sarah L.
Stephan, Christoph
Kunisaki, Ken M.
Title Biomarkers and bacterial pneumonia risk in patients with treated HIV infection: a case-control study
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2013-02-15
Sub-type Article (original research)
DOI 10.1371/journal.pone.0056249
Open Access Status DOI
Volume 8
Issue 2
Total pages 8
Place of publication San Francisco, United States
Publisher Public Library of Science
Language eng
Formatted 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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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