Procalcitonin as a marker of bacterial sepsis in patients infected with HIV-1

• Published in: The Journal of infection 1997-07, Vol.35 (1), p.41-46
• Main Authors: Gerard, Y., Hober, D., Assicot, M., Alfandari, S., Ajana, F., Bourez, J.M., Chidiac, C., Mouton, Y., Bohuon, C., Wattre, P.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; AIDS-Related Opportunistic Infections - complications; AIDS/HIV; Bacteremia - blood; Bacteremia - complications; Bacteremia - microbiology; Biological and medical sciences; Biomarkers - blood; Calcitonin - blood; Calcitonin Gene-Related Peptide; HIV-1; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Male; Medical sciences; Middle Aged; Prospective Studies; Protein Precursors - blood
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/S0163-4453(97)90953-1

Procalcitonin (ProCT) is a recently described marker of severe sepsis. It was decided to assess the value of proCT as a marker of secondary infection in patients infected with HIV-1. ProCT plasma levels were measured by immunoluminometric assay in a prospective study in 155 HIV-infected individuals: 102 asymptomatic and 53 with fever or suspected secondary infections. The baseline plasma level of ProCT was low (0.5 ng/ml ± 0.37), even in the latest stages of the disease, and did not differ from the values of healthy subjects (0.54 ng/ml ± 0.08). EDTA-treated whole blood was collected from patients before starting specific antimicrobial therapy. No elevation of ProCT level was detected in HIV-infected patients with evolving secondary infections including PCP ( n = 4), cerebral toxoplasmosis ( n = 4), viral infections ( n = 9), mycobacterial infections ( n = 5), localized bacterial ( n = 12) and fungal infections ( n = 4), malignancies ( n = 3), and in various associated infectious and non-infectious febrile events ( n = 13). All these plasma values were lower than 2.1 ng/ml. In contrast, high ProCT plasma levels were detected in one HIV-infected patient with a septicaemic Haemophilus influenzae infection (16.5 ng/ml) and another one with a septicaemic Pseudomonas aeruginosa infection (44.1 ng/ml). ProCT values decreased rapidly under appropriate therapy. ProCT seems to be a specific marker of bacterial sepsis in HIV-infected patients, as no increase in other secondary infections could be detected in those patients. A rapid determination of ProCT level could be useful to confirm or refute bacterial sepsis for a better management of febrile HIV-infected patients.