The association of serum lactate dehydrogenase level with selected opportunistic infections and HIV progression.
BACKGROUND
The purpose of this study was to determine the association of serum lactate dehydrogenase (LDH) levels with certain opportunistic infection and to determine an association between LDH levels and CD4+ lymphocyte counts.


METHODS
We studied 352 patients retrospectively with HIV infection and one of the following infections: histoplasmosis; toxoplasmosis; tuberculosis (pulmonary and disseminated); bacterial pneumonia; Pneumocystis carinii pneumonia. Demographic and clinical data were obtained from the Adult Spectrum of Diseases (ASD) database in New Orleans. Bivariate and multivariate analysis were used to determine the association between LDH levels and opportunistic infections and CD4+ lymphocyte counts.


RESULTS
Patients with a serum LDH level <225 IU/L had a mean CD4+ lymphocyte count of 159/dl (SE 19.3) as compared to patients with a serum LDH level > or =225 IU/L, who had a mean CD4+ lymphocyte count of 58/dl (SE 6.9) (P<0.01). Non-Caucasian race, a diagnosis of histoplasmosis, disseminated tuberculosis or Pneumocystis carinii pneumonia, and CD4+ lymphocyte count were significantly associated with a serum LDH level > or =225 IU/L in the bivariate analysis. In a multivariate analysis, after controlling for race and CD4+ lymphocyte count, the only diagnoses that were significantly associated with the serum LDH level were definitive Pneumocystis carinii pneumonia and toxoplasmosis. Having a higher LDH level was not associated with early mortality.


CONCLUSIONS
Although not diagnostic, serum LDH levels could be used as an adjunctive marker in certain opportunistic infections. There is an inverse relationship between serum LDH levels and CD4+ lymphocyte counts in this group.
Butt
Adeel A
AA
Louisiana State University Health Sciences Center, New Orleans, USA. butt@msx.dept-med.pitt.edu
Michaels
Stephanie
S
Kissinger
Patricia
P
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000201:enzymology; D000328:Adult; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications; D006660:Histoplasmosis / Q000175:diagnosis* / Q000201:enzymology; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis* / Q000201:enzymology; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000201:enzymology
D007770:L-Lactate Dehydrogenase