Inflammatory pattern in HIV patients with Community acquired pneumonia and it's relationship with pulmonary dysfunction.
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Date
2018-08-23
Authors
Mao, Tony
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Abstract
Prior studies have shown that HIV patients develop permanent pulmonary dysfunction following an episode of community acquired pneumonia (CAP). However, the mechanism causing pulmonary dysfunction remains an enigma. HIV patients experience chronic inflammation. We hypothesized that CAP infection worsens inflammation in HIV patients which leads to an accelerated decline in pulmonary function. A prospective cohort pilot study was performed, participants include patients hospitalized in Hospital Universitario San Vicente Fundación and Clínica SOMA, in Medellín, Colombia. Sixteen patients were eligible for the study, they were split into two groups: HIV and HIV+CAP. Plasma, sputum and pulmonary function test (PFT) measurements were retrieved within 48 hours of hospital admission and at one month follow-up. The concentrations of 13 molecules and PFT values were compared between the two cohorts. HIV+CAP group demonstrated a decline in pulmonary function compared to the HIV group, FVC%predicted and FEV1%predicted decreased while FEV1/FVC remained constant. APRIL, BAFF and TIMP-1 trended towards higher concentrations in the HIV+CAP group compared to the HIV group. These three molecules correlated negatively with FVC%predicted and FEV1%predicted, they have the potential to serve as biomarkers for predicting pulmonary dysfunction. Furthermore, the concentrations of BAFF, CCL3 and TIMP-1 were statistically significant between the two groups (=0.05). These molecules are involved in inflammation response in humans. We speculate that abnormal expression of these molecules may play a role in dysregulating inflammatory response, which leads to pulmonary dysfunction. These results need to be replicated with larger cohorts and longer follow-up time (to assess for permanent pulmonary dysfunction).
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Keywords
community acquired pneumonia (CAP), HIV, pulmonary function test (PFT), pulmonary dysfunction
Citation
AMA