Cellular immune response to pulmonary infections in HIV-infected individuals hospitalized with diverse grades of immunosuppression.
The lymphocyte profile of 521 HIV-infected subjects hospitalized at Jackson Memorial (2001-2002) was compared across main respiratory diseases. Study data included medical history and all laboratory evaluations performed during hospitalization. Community-acquired pneumonias (CAP, 52%), Pneumocystis jiroveci pneumonia (PCP, 24%), tuberculosis (TB, 9%) and non-tuberculous mycobacterial diseases (NTM, 12%) were the most frequent causes of admission. Patients hospitalized with PCP and NTM exhibited the lowest CD4 counts (P=0.003). PCP patients had the highest B-cell percentages (P=0.04). CAP patients had the highest CD8 and CD4 percentages and the lowest percentage of Natural Killer (NK) cells and viral burdens. TB patients exhibited the lowest NK-cell (11.4+/-6.3) and B-cell percentages (13.6+/-12) and the highest CD8 (59+/-14) percentage. NTM patients, in contrast, had the highest NK-cell percentages of the groups (19.1+/-11.6, P=0.01). Additionally, immune responses associated with respiratory pathogens differed in HIV-infected patients with CD4(+) cells above and below 200 counts.
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL 33136, USA. mmiguez@med.miami.edu
M J
MJ
Miguez-Burbano
D
D
Ashkin
A
A
Rodriguez
R
R
Duncan
M
M
Flores
B
B
Acosta
N
N
Quintero
A
A
Pitchenik
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D017714:Community-Acquired Infections; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D016867:Immunocompromised Host; D007297:Inpatients; D007694:Killer Cells, Natural; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000276:immunology* / Q000628:therapy; D012720:Severity of Illness Index; D014397:Tuberculosis, Pulmonary / Q000276:immunology* / Q000628:therapy