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(1–3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients

Esteves, F. ; Lee, C.-H. ; de Sousa, B. ; Badura, R. ; Seringa, M. ; Fernandes, C. ; Gaspar, J. F. ; Antunes, F. ; Matos, O.

European journal of clinical microbiology & infectious diseases, 2014-07, Vol.33 (7), p.1173-1180 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
(1–3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients
Autor: Esteves, F. ; Lee, C.-H. ; de Sousa, B. ; Badura, R. ; Seringa, M. ; Fernandes, C. ; Gaspar, J. F. ; Antunes, F. ; Matos, O.
Assuntos: Adult ; Aged ; beta-Glucans - blood ; Biological and medical sciences ; Biomarkers ; Biomarkers - blood ; Biomedical and Life Sciences ; Biomedicine ; Blood & organ donations ; Dehydrogenases ; Female ; HIV ; HIV Infections - complications ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Internal Medicine ; L-Lactate Dehydrogenase - blood ; Male ; Medical Microbiology ; Medical sciences ; Middle Aged ; Monoclonal antibodies ; Pathogens ; Pneumocystis ; Pneumology ; Pneumonia ; Pneumonia, Pneumocystis - diagnosis ; Predictive Value of Tests ; Respiratory system : syndromes and miscellaneous diseases ; Sensitivity and Specificity ; Serum - chemistry ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult
É parte de: European journal of clinical microbiology & infectious diseases, 2014-07, Vol.33 (7), p.1173-1180
Notas: ObjectType-Article-2
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Descrição: Pneumocystis pneumonia (PcP) is a major HIV-related illness caused by Pneumocystis jirovecii . Definitive diagnosis of PcP requires microscopic detection of P. jirovecii in pulmonary specimens. The objective of this study was to evaluate the usefulness of two serum markers in the diagnosis of PcP. Serum levels of (1–3)-beta-d-glucan (BG) and lactate dehydrogenase (LDH) were investigated in 100 HIV-positive adult patients and 50 healthy blood donors. PcP cases were confirmed using indirect immunofluorescence with monoclonal anti- Pneumocystis antibodies and nested-PCR to amplify the large subunit mitochondrial rRNA gene of P. jirovecii in pulmonary specimens. BG and LDH levels in serum were measured using quantitative microplate-based assays. BG and LDH positive sera were statistically associated with PcP cases ( P ≤ 0.001). Sensitivity, specificity, positive/negative predictive values (PPV/NPV), and positive/negative likelihood ratios (PLR/NLR) were 91.3 %, 61.3 %, 85.1 %, 79.2 %, 2.359, and 0.142, respectively, for the BG kit assay, and 91.3 %, 35.5 %, 75.9 %, 64.7 %, 1.415 and 0.245, respectively, for the LDH test. Serologic markers levels combined with the clinical diagnostic criteria for PcP were evaluated for their usefulness in diagnosis of PcP. The most promising cutoff levels for diagnosis of PcP were determined to be 400 pg/ml of BG and 350 U/l of LDH, which combined with clinical data presented 92.8 % sensitivity, 83.9 % specificity, 92.8 % PPV, 83.9 % NPV, 5.764 PLR and 0.086 NLR ( P < 0.001). This study confirmed that BG is a reliable indicator for detecting P. jirovecii infection. The combination between BG/LDH levels and clinical data is a promising alternative approach for PcP diagnosis.
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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(1–3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients

Esteves, F. ; Lee, C.-H. ; de Sousa, B. ; Badura, R. ; Seringa, M. ; Fernandes, C. ; Gaspar, J. F. ; Antunes, F. ; Matos, O.

Berlin/Heidelberg: Springer Berlin Heidelberg

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