title: Procalcitonin as a marker of bacterial sepsis in patients infected with HIV-1.
abstract: Procalcitonin (ProCT) is a recently described marker of severe sepsis. It was decided to assess the value of proCT as a marker of secondary infection in patients infected with HIV-1. ProCT plasma levels were measured by immunoluminometric assay in a prospective study in 155 HIV-infected individuals: 102 asymptomatic and 53 with lever or suspected secondary infections. The baseline plasma level of ProCT was low (0.5 ng/ml +/- 0.37), even in the latest stages of the disease, and did not differ from the values of healthy subjects (0.54 ng/ml +/- 0.08). EDTA-treated whole blood was collected from patients before starting specific antimicrobial therapy. No elevation of ProCT level was detected in HIV-infected patients with evolving secondary infections including PCP (n = 4), cerebral toxoplasmosis (n = 4), viral infections (n = 9), mycobacterial infections (n = 5), localized bacterial (n = 12) and fungal infections (n = 4), malignancies (n = 3), and in various associated infectious and non-infectious febrile events (n = 13). All these plasma values were lower than 2.1 ng/ml. In contrast, high ProCT plasma levels were detected in one HIV-infected patient with a septicaemic Haemophilus influenzae infection (16.5 ng/ml) and another one with a septicaemic Pseudomonas aeruginosa infection (44.1 ng/ ml), ProCT values decreased rapidly under appropriate therapy. ProCT seems to be a specific marker of bacterial sepsis in HIV-infected patients, as no increase in other secondary infections could be detected in those patients. A rapid determination of ProCT level could be useful to confirm or refute bacterial sepsis for a better management of febrile HIV-infected patients.
authors.affiliation: Laboratoire de Virologie, Bâtiment I.R.F.P.P.S., CHU, Lille, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Gérard
authors.forename: D
authors.initials: D
authors.lastname: Hober
authors.forename: M
authors.initials: M
authors.lastname: Assicot
authors.forename: S
authors.initials: S
authors.lastname: Alfandari
authors.forename: F
authors.initials: F
authors.lastname: Ajana
authors.forename: J M
authors.initials: JM
authors.lastname: Bourez
authors.forename: C
authors.initials: C
authors.lastname: Chidiac
authors.forename: Y
authors.initials: Y
authors.lastname: Mouton
authors.forename: C
authors.initials: C
authors.lastname: Bohuon
authors.forename: P
authors.initials: P
authors.lastname: Wattre
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000150:complications* / Q000382:microbiology; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide