Low levels of mannan-binding lectin or ficolins are not associated with an increased risk of cytomegalovirus disease in HIV-infected patients

• Published in: PloS one 2013-01, Vol.8 (1), p.e51983-e51983
• Main Authors: Egli, Adrian, Schäfer, Juliane, Osthoff, Michael, Thiel, Steffen, Mikkelsen, Christina, Rauch, Andri, Hirsch, Hans H, Bucher, Heiner C, Young, James, Jensenius, Jens C, Battegay, Manuel, Trendelenburg, Marten
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Antiretroviral agents; Antiretroviral therapy; Binding; Biology; Case-Control Studies; CD4 antigen; Cohort Studies; Control methods; Cytomegalovirus; Cytomegalovirus - isolation & purification; Cytomegalovirus infections; Cytomegalovirus Infections - blood; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - etiology; Disease control; Enzyme-linked immunosorbent assay; Epidemiology; Female; Ficolins; Health aspects; Health risks; HIV; HIV - isolation & purification; HIV Infections - blood; HIV Infections - complications; HIV Infections - diagnosis; HIV patients; Hospitals; Human immunodeficiency virus; Humans; Immunology; Infections; Infectious diseases; Laboratories; Lectins; Lectins - blood; Lymphocytes T; M-ficolin; Male; Mannan; Mannose-binding lectin; Mannose-Binding Lectin - blood; Medical prognosis; Medicine; Middle Aged; Patients; Plasma levels; Ribonucleic acid; Risk Factors; RNA; Severe acute respiratory syndrome; Stem cells; Transplantation; Transplants & implants; Viruses; West Nile virus
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0051983

In HIV-infected patients, prediction of Cytomegalovirus (CMV) disease remains difficult. A protective role of mannan-binding lectin (MBL) and ficolins against CMV disease has been reported after transplantation, but the impact in HIV-infected patients is unclear. In a case-control study nested within the Swiss HIV Cohort Study, we investigated associations between plasma levels of MBL/ficolins and CMV disease. We compared HIV-infected patients with CMV disease (cases) to CMV-seropositive patients without CMV disease (controls) matched for CD4 T-cells, sampling time, and use of combination antiretroviral therapy. MBL and M-ficolin, L-ficolin, and H-ficolin were quantified using ELISA. We analysed 105 cases and 105 matched controls. CMV disease was neither associated with MBL (odds ratio [OR] 1.03 per log(10) ng/mL increase (95% CI 0.73-1.45)) nor with ficolins (OR per log(10) ng/mL increase 0.66 (95% CI 0.28-1.52), 2.34 (95% CI 0.44-12.36), and 0.89 (95% CI 0.26-3.03) for M-ficolin, L-ficolin, and H-ficolin, respectively). We found no evidence of a greater association between MBL and CMV disease in patients with low CD4 counts; however in the multivariable analysis, CMV disease was more likely in patients with an increased HIV RNA (OR 1.53 per log(10) copies/mL; 95% CI 1.08-2.16), or a shorter duration of HIV-infection (OR 0.91 per year; 95% CI 0.84-0.98). CMV disease is not associated with low levels of MBL/ficolins, suggesting a lack of a protective role in HIV-infected patients.