The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2017;21:606-12 - Vol. 21 Num.6 DOI: 10.1016/j.bjid.2017.07.002
Original article
Serum markers as an aid in the diagnosis of pulmonary fungal infections in AIDS patients
Ana Isabela Morsch Passosa, Rachel Polo Dertkigilb, Marcelo de Carvalho Ramosa, Ariane Fidelis Busso-Lopesd, Cibele Tararana, Erivan Olinda Ribeiroa, Angélica Zaninelli Schreiberc, Plinio Trabassoa, Mariangela Ribeiro Resendea, Maria Luiza Morettia,, ,
a Universidade de Campinas, Faculdade de Ciências Médicas, Departamento de Medicina Interna, Campinas, SP, Brazil
b Universidade de Campinas, Faculdade de Ciências Médicas, Departamento de Radiologia, Campinas, SP, Brazil
c Universidade de Campinas, Faculdade de Ciências Médicas, Departamento de Patologia Clínica, Campinas, SP, Brazil
d Laboratório Nacional de Biociências (LNBio), Campinas, SP, Brazil
Received 09 March 2017, Accepted 09 July 2017
Abstract
Introduction

The etiology of pulmonary infections in HIV patients is determined by several variables including geographic region and availability of antiretroviral therapy.

Materials and methods

A cross-sectional prospective study was conducted from 2012 to 2016 to evaluate the occurrence of pulmonary fungal infection in HIV-patients hospitalized due to pulmonary infections. Patients’ serums were tested for (1–3)-β-D-Glugan, galactomannan, and lactate dehydrogenase. The association among the variables was analyzed by univariate and multivariate regression analysis.

Results

60 patients were included in the study. The patients were classified in three groups: Pneumocystis jirovecii pneumonia (19 patients), community-acquired pneumonia (18 patients), and other infections (23 patients). The overall mortality was 13.3%. The time since diagnosis of HIV infection was shorter in the pneumocystosis group (4.94 years; p=0.001) than for the other two groups of patients. The multivariate analysis showed that higher (1-3)-β-D-Glucan level (mean: 241pg/mL) and lactate dehydrogenase (mean: 762U/L) were associated with the diagnosis of pneumocystosis. Pneumocystosis was the aids-defining illness in 11 out of 16 newly diagnosed HIV-infected patients.

Conclusion

In the era of antiretroviral therapy, PJP was still the most prevalent pulmonary infection and (1-3)-β-D-Glucan and lactate dehydrogenase may be suitable markers to help diagnosing pneumocystosis in our HIV population.

Keywords
Pulmonary infection, HIV/AIDS, (1-3)-β-D-Glugan, LDH, LAMP, Pneumocystosis, Fungal infection
Braz J Infect Dis 2017;21:606-12 - Vol. 21 Num.6 DOI: 10.1016/j.bjid.2017.07.002