Abstract
BACKGROUND: To determine plasma immune-inflammatory biomarkers that may predict in-hospital mortality in HIV-infected individuals diagnosed with pneumocystis jirovecii pneumonia (PCP). [Figure: see text] [Figure: see text] METHODS: This study prospectively included 125 HIV-infected patients with PCP. Biomarkers involving clinical variables and 8 pre-selected plasma inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, IL-2, IL-4, IL-6, IL-10, IL-12, IL-17, TNF-α, and IFN-γ) were evaluated at time of admission. Multivariate logistic regression analysis was used to identify factors substantially associated with in-hospital mortality. The predictive value of the biomarkers for in-hospital mortality was assessed using the ROC curve. RESULTS: Our results show a hospital mortality rate of 12.8% (16/125). When compared to surviving AIDS PCP patients, non-survivors had substantially higher levels of C-reactive protein, IL-6, aspartate aminotransferase, and lactate dehydrogenase and lower levels of albumin, PO(2), and CD4 count. We found a significant association between increased IL-6 levels and hospital mortality using multivariable logistic regression analysis (adjusted odd ratio, 1.006; 95% CI, 1.002-1.012; P = 0.012). The plasma IL-6 levels had a maximum area under the Area Under Curve (AUC) (0.883; 95%CI, 0.812-0.953), compared to CD4+ T cell (AUC, 0.789; 95%CI, 0.697-0.881), ALB (AUC, 0.776; 95%CI, 0.661-0.892), and LDH (AUC, 0.703; 95%CI, 0.573-0.832). CONCLUSION: A high level of plasma IL-6 has been associated to an elevated probability of in-hospital mortality. DISCLOSURES: All Authors: No reported disclosures