Chen Ruifang, Ren Shuai, Tang Haicheng, Wu Qingguo
Department of Respiratory and Critical Care Medicine, Shanghai Public Health Clinical Center, No 2901, Caolang Road, Jinshan District, Shanghai, 201508, China.
BMC Infect Dis. 2025 Sep 2;25(1):1096. doi: 10.1186/s12879-025-11425-0.
To evaluate the impact of Human Immunodeficiency Virus (HIV) infection on serum amyloid A (SAA) levels in acute pulmonary infections and assess correlations between SAA and other inflammatory markers in HIV-associated pneumonia.
In this retrospective case-control study, 48 HIV-positive patients with pulmonary infections (HIV group) and 55 age-matched HIV-negative controls (control group) were enrolled from Shanghai Public Health Clinical Center (2021.5-2025.5). Demographic, hospitalization duration and laboratory parameters - including SAA, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), platelet count (PLT), CD4 T cell count, and absolute lymphocyte count(ALC) - were systematically collected from both patient cohorts. For intergroup comparisons, the Mann-Whitney U test was employed, while Spearman's rank correlation analysis was conducted to assess biomarker associations within the HIV-positive subgroup.
Among 103 patients, the HIV group had higher male predominance (83.3% vs. 54.5%, P = 0.02) and lower CD4 T cell count (215.17 vs. 443.41 cells/µL, P < 0.05). SAA (178.39 vs. 122.93 mg/L, P = 0.032), CRP (64.27 vs. 37.07 mg/L, P = 0.031), LDH (310.65 vs. 235.96 U/L, P = 0.024), and hospitalization duration (16.83 vs. 13.05 days, P = 0.013) were significantly elevated in HIV patients. SAA correlated positively with CRP (r = 0.4807), PCT (r = 0.3554), LDH (r = 0.3564), and PLT (r = 0.3094) (P < 0.05 for all).
Patients with HIV-associated pulmonary infections exhibited significantly elevated levels of SAA, CRP, and LDH, along with prolonged hospital stays, compared to non-HIV-infected individuals. These findings suggest that HIV infection amplifies systemic inflammatory responses, potentially contributing to extended hospitalization. The robust correlations between SAA and other biomarkers (including CRP, PCT, LDH, PLT) highlight its potential as a key component in early diagnostic panels for HIV-associated pulmonary infections.
评估人类免疫缺陷病毒（HIV）感染对急性肺部感染患者血清淀粉样蛋白A（SAA）水平的影响，并评估SAA与HIV相关性肺炎中其他炎症标志物之间的相关性。
在这项回顾性病例对照研究中，从上海公共卫生临床中心（2021年5月至2025年5月）招募了48例HIV阳性肺部感染患者（HIV组）和55例年龄匹配的HIV阴性对照者（对照组）。系统收集了两组患者的人口统计学资料、住院时间和实验室参数，包括SAA、白细胞计数（WBC）、C反应蛋白（CRP）、降钙素原（PCT）、乳酸脱氢酶（LDH）、血小板计数（PLT）、CD4 T细胞计数和绝对淋巴细胞计数（ALC）。组间比较采用Mann-Whitney U检验，Spearman等级相关分析用于评估HIV阳性亚组内生物标志物之间的关联。
在103例患者中，HIV组男性占比更高（83.3%对54.5%，P = 0.02），CD4 T细胞计数更低（215.17对443.41个/μL，P < 0.05）。HIV患者的SAA（178.39对122.93 mg/L，P = 0.032）、CRP（64.27对37.07 mg/L，P = 0.031）、LDH（310.65对235.96 U/L，P = 0.024）和住院时间（16.83对13.05天，P = 0.013）显著升高。SAA与CRP（r = 0.4807）、PCT（r = 0.3554）、LDH（r = 0.3564）和PLT（r = 0.3094）呈正相关（均P < 0.05）。
与未感染HIV的个体相比，HIV相关性肺部感染患者的SAA、CRP和LDH水平显著升高，住院时间延长。这些发现表明，HIV感染会放大全身炎症反应，可能导致住院时间延长。SAA与其他生物标志物（包括CRP、PCT、LDH、PLT）之间的强相关性突出了其作为HIV相关性肺部感染早期诊断指标关键组成部分的潜力。
