1. Deficiency of mannose-binding lectin is a risk of Pneumocystis jirovecii pneumonia in a natural history cohort of people living with HIV/AIDS in Northern Thailand.
- Author
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Yanagisawa K, Wichukchinda N, Tsuchiya N, Yasunami M, Rojanawiwat A, Tanaka H, Saji H, Ogawa Y, Handa H, Pathipvanich P, Ariyoshi K, and Sawanpanyalert P
- Subjects
- AIDS-Related Opportunistic Infections diagnosis, AIDS-Related Opportunistic Infections genetics, AIDS-Related Opportunistic Infections microbiology, Adolescent, Adult, Female, Follow-Up Studies, Genetic Predisposition to Disease, Genotyping Techniques, Humans, Immunity, Innate genetics, Incidence, Male, Mannose-Binding Lectin genetics, Mannose-Binding Lectin immunology, Middle Aged, Pneumocystis carinii immunology, Pneumonia, Pneumocystis diagnosis, Pneumonia, Pneumocystis genetics, Pneumonia, Pneumocystis microbiology, Prospective Studies, Risk Factors, Thailand epidemiology, Young Adult, AIDS-Related Opportunistic Infections epidemiology, Mannose-Binding Lectin deficiency, Pneumocystis carinii isolation & purification, Pneumonia, Pneumocystis epidemiology
- Abstract
Background: Mannose-binding lectin (MBL) plays a pivotal role in innate immunity; however, its impact on susceptibility to opportunistic infections (OIs) has not yet been examined in a natural history cohort of people living with HIV/AIDS., Methods: We used archived samples to analyze the association between MBL expression types and risk of major OIs including Pneumocystis jirovecii pneumonia (PCP), cryptococcosis, talaromycosis, toxoplasmosis, and tuberculosis in a prospective cohort in Northern Thailand conducted from 1 July 2000 to 15 October 2002 before the national antiretroviral treatment programme was launched., Results: Of 632 patients, PCP was diagnosed in 96 (15.2%) patients, including 45 patients with new episodes during the follow-up period (1006.5 person-years). The total history of PCP was significantly associated with low MBL expression type: high/intermediate (81/587, 13.8%), low (10/33, 30.3%) and deficient (5/12, 41.7%) (p = 0.001), whereas the history of other OIs showed no relation with any MBL expression type. Kaplan-Meier analysis (n = 569; log-rank p = 0.011) and Cox's proportional hazards model revealed that deficient genotype dramatically increased the risk of PCP, which is independent upon sex, age, CD4 count, HIV-1 viral load and hepatitis B and C status (adjusted hazard ratio 7.93, 95% confidence interval 2.19-28.67, p = 0.002)., Conclusions: Deficiency of MBL expression is a strong risk factor determining the incidence of PCP but not other major OIs., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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