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

F. Esteves, Chao-Hung Lee, B. De Sousa, R. Badura, M. Seringa, C. Fernandes, J. F. Gaspar, F. Antunes, O. Matos

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1173-1180
Number of pages8
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume33
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Pneumocystis Pneumonia
L-Lactate Dehydrogenase
beta-Glucans
Biomarkers
HIV
Pneumocystis carinii
Serum
Pneumocystis
Pneumocystis Infections
beta-1,3-D-glucan
Sensitivity and Specificity
Lung
Mitochondrial Genes
Indirect Fluorescent Antibody Technique
Blood Donors
rRNA Genes
Anti-Idiotypic Antibodies
Monoclonal Antibodies
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

(1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients. / Esteves, F.; Lee, Chao-Hung; De Sousa, B.; Badura, R.; Seringa, M.; Fernandes, C.; Gaspar, J. F.; Antunes, F.; Matos, O.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 33, No. 7, 2014, p. 1173-1180.

Research output: Contribution to journalArticle

Esteves, F. ; Lee, Chao-Hung ; De Sousa, B. ; Badura, R. ; Seringa, M. ; Fernandes, C. ; Gaspar, J. F. ; Antunes, F. ; Matos, O. / (1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients. In: European Journal of Clinical Microbiology and Infectious Diseases. 2014 ; Vol. 33, No. 7. pp. 1173-1180.
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abstract = "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.",
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T1 - (1-3)-Beta-D-glucan in association with lactate dehydrogenase as biomarkers of Pneumocystis pneumonia (PcP) in HIV-infected patients

AU - Esteves, F.

AU - Lee, Chao-Hung

AU - De Sousa, B.

AU - Badura, R.

AU - Seringa, M.

AU - Fernandes, C.

AU - Gaspar, J. F.

AU - Antunes, F.

AU - Matos, O.

PY - 2014

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