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Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon
BACKGROUND: The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394190/ https://www.ncbi.nlm.nih.gov/pubmed/34445956 http://dx.doi.org/10.1186/s12879-021-06566-x |
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author | Gama, Wellington Mota Frank, Carlos Henrique Michiles Almeida, Taynná Vernalha Rocha dos Santos, Daniel Silva Chaves, Yury Oliveira da Silva, Danielle Furtado Orlandi, Patrícia Puccinelli Pereira, Flávio Ribeiro Magalhães, Gleicienne Feliz Baptista, Bárbara Jóse de Oliveira Silva, Viviane Lago da Silva Balieiro, Antônio Alcirley Santana, Monique Freire Gonçalves, Roberta Lins da Costa, Allyson Guimarães dos Santos, Marcelo Cordeiro de Lima Ferreira, Luís Carlos Lacerda, Marcus Vinicius Guimaraes Nogueira, Paulo Afonso |
author_facet | Gama, Wellington Mota Frank, Carlos Henrique Michiles Almeida, Taynná Vernalha Rocha dos Santos, Daniel Silva Chaves, Yury Oliveira da Silva, Danielle Furtado Orlandi, Patrícia Puccinelli Pereira, Flávio Ribeiro Magalhães, Gleicienne Feliz Baptista, Bárbara Jóse de Oliveira Silva, Viviane Lago da Silva Balieiro, Antônio Alcirley Santana, Monique Freire Gonçalves, Roberta Lins da Costa, Allyson Guimarães dos Santos, Marcelo Cordeiro de Lima Ferreira, Luís Carlos Lacerda, Marcus Vinicius Guimaraes Nogueira, Paulo Afonso |
author_sort | Gama, Wellington Mota |
collection | PubMed |
description | BACKGROUND: The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. METHODS: The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. RESULTS: The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. CONCLUSIONS: The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients. |
format | Online Article Text |
id | pubmed-8394190 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83941902021-08-30 Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon Gama, Wellington Mota Frank, Carlos Henrique Michiles Almeida, Taynná Vernalha Rocha dos Santos, Daniel Silva Chaves, Yury Oliveira da Silva, Danielle Furtado Orlandi, Patrícia Puccinelli Pereira, Flávio Ribeiro Magalhães, Gleicienne Feliz Baptista, Bárbara Jóse de Oliveira Silva, Viviane Lago da Silva Balieiro, Antônio Alcirley Santana, Monique Freire Gonçalves, Roberta Lins da Costa, Allyson Guimarães dos Santos, Marcelo Cordeiro de Lima Ferreira, Luís Carlos Lacerda, Marcus Vinicius Guimaraes Nogueira, Paulo Afonso BMC Infect Dis Research Article BACKGROUND: The irregular use of antiretroviral therapy (ART) and late diagnosis still account for a large part of HIV-associated mortality in people living with HIV (PLHIV). Herein, we describe HIV-associated morbidity among hospitalised HIV/AIDS patients with advanced immunosuppression and assess the comorbidities, laboratory parameters, and immunological markers associated with mortality. METHODS: The cross-sectional study was conducted at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) in Manaus, Brazil. In all, 83 participants aged between 12 and 70 years were enrolled by convenience within 72 h of their hospitalisation. Clinical and laboratory data were obtained from electronic medical records. We prospectively measured the cytokines Th1/Th2/Th17 and inflammatory cytokines IL-8, IL-1β, and IL-12 using cytometric bead array, and the soluble CD14 using in-house enzyme-linked immunosorbent assay. RESULTS: The HIV/AIDS inpatients presented a scenario of respiratory syndromes as the most prevalent comorbidity. Almost all patients had CD4 T counts below 350 cells/mL and the mortality rate was 20.5%. Pulmonary tuberculosis, neurotoxoplasmosis and oropharyngeal–esophageal candidiasis were the most prevalent opportunistic infections. TB and weight loss were more prevalent in HIV/AIDS inpatients who died. The Mann Whitney analysis showed that those who died had higher platelet distribution width (PDW) on admission, which is suggestive for platelet activation. The Poisson multivariate analysis showed the prevalence of TB, digestive syndrome and increases in IL-8 and lactate dehydrogenase (LDH) associated to death. CONCLUSIONS: The advanced immunosuppression characterized by the opportunistic infections presented in these HIV/AIDS inpatients was the major factor of mortality. The role of platelet activation in worse outcomes of hospitalisation and the IL-8 associated with the context of advanced immunosuppression may be promising markers in the prediction of mortality in HIV/AIDS patients. BioMed Central 2021-08-26 /pmc/articles/PMC8394190/ /pubmed/34445956 http://dx.doi.org/10.1186/s12879-021-06566-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Gama, Wellington Mota Frank, Carlos Henrique Michiles Almeida, Taynná Vernalha Rocha dos Santos, Daniel Silva Chaves, Yury Oliveira da Silva, Danielle Furtado Orlandi, Patrícia Puccinelli Pereira, Flávio Ribeiro Magalhães, Gleicienne Feliz Baptista, Bárbara Jóse de Oliveira Silva, Viviane Lago da Silva Balieiro, Antônio Alcirley Santana, Monique Freire Gonçalves, Roberta Lins da Costa, Allyson Guimarães dos Santos, Marcelo Cordeiro de Lima Ferreira, Luís Carlos Lacerda, Marcus Vinicius Guimaraes Nogueira, Paulo Afonso Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title | Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title_full | Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title_fullStr | Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title_full_unstemmed | Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title_short | Immunologic biomarkers, morbidity and mortality among HIV patients hospitalised in a Tertiary Care Hospital in the Brazilian Amazon |
title_sort | immunologic biomarkers, morbidity and mortality among hiv patients hospitalised in a tertiary care hospital in the brazilian amazon |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394190/ https://www.ncbi.nlm.nih.gov/pubmed/34445956 http://dx.doi.org/10.1186/s12879-021-06566-x |
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