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Cellular immune response to pulmonary infections in HIV-infected individuals hospitalized with diverse grades of immunosuppression

Published online by Cambridge University Press:  19 August 2005

M. J. MIGUEZ-BURBANO
Affiliation:
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, USA
D. ASHKIN
Affiliation:
A. G. Holley State Tuberculosis Hospital, Lantana, FL, USA
A. RODRIGUEZ
Affiliation:
Clinical Infectious Diseases, University of Miami School of Medicine, Miami, FL, USA
R. DUNCAN
Affiliation:
Epidemiology & Public Health, University of Miami School of Medicine, Miami, FL, USA
M. FLORES
Affiliation:
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Fogarty International Program for HIV/TB, University of Miami School of Medicine, Miami, FL, USA
B. ACOSTA
Affiliation:
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Fogarty International Program for HIV/TB, University of Miami School of Medicine, Miami, FL, USA
N. QUINTERO
Affiliation:
Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, USA
A. PITCHENIK
Affiliation:
Pulmonary Division, University of Miami and VA Medical Centers, VA Hospital, Miami, FL, USA
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Abstract

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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.

Type
Research Article
Copyright
2005 Cambridge University Press