دورية أكاديمية
Association of Antibody Immunity With Cryptococcal Antigenemia and Mortality in a South African Cohort With Advanced Human Immunodeficiency Virus Disease.
العنوان: | Association of Antibody Immunity With Cryptococcal Antigenemia and Mortality in a South African Cohort With Advanced Human Immunodeficiency Virus Disease. |
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المؤلفون: | Yoon H; Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA., Wake RM; Institute for Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, United Kingdom.; Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.; Clinical Academic Group in Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, United Kingdom., Nakouzi AS; Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.; Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA., Wang T; Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA., Agalliu I; Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.; Department of Urology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA., Tiemessen CT; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; Centre for HIV & STIs, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa., Govender NP; Institute for Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, United Kingdom.; Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa.; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.; MRC Center for Medical Mycology, University of Exeter, Exeter, United Kingdom.; Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa., Jarvis JN; Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.; Botswana Harvard AIDS Institute Partnership, Botswana, Southern Africa., Harrison TS; Institute for Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, United Kingdom.; Clinical Academic Group in Infection and Immunity, St George's University Hospital NHS Foundation Trust, London, United Kingdom.; MRC Center for Medical Mycology, University of Exeter, Exeter, United Kingdom., Pirofski LA; Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA.; Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA. |
المصدر: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Feb 18; Vol. 76 (4), pp. 649-657. |
نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Jan. 2011- : Oxford : Oxford University Press Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
مواضيع طبية MeSH: | Cryptococcus* , HIV Infections*/complications , Meningitis, Cryptococcal*/diagnosis, Adult ; Humans ; Prospective Studies ; South Africa ; CD4 Lymphocyte Count ; Antigens, Fungal ; Immunoglobulin G ; HIV |
مستخلص: | Background: Asymptomatic cryptococcal antigenemia (positive blood cryptococcal antigen [CrAg]) is associated with increased mortality in individuals with human immunodeficiency virus (HIV) even after adjusting for CD4 count and despite receiving antifungal treatment. The association of antibody immunity with mortality in adults with HIV with cryptococcal antigenemia is unknown. Methods: Cryptococcal capsular glucuronoxylomannan (GXM)- and naturally occurring β-glucans (laminarin, curdlan)-binding antibodies were measured in blood samples of 197 South Africans with HIV who underwent CrAg screening and were followed up to 6 months. Associations between antibody titers, CrAg status, and all-cause mortality were sought using logistic and Cox regression, respectively. Results: Compared with CrAg-negative individuals (n = 130), CrAg-positive individuals (n = 67) had significantly higher IgG1 (median, 6672; interquartile range [IQR], 4696-10 414 vs 5343, 3808-7722 μg/mL; P = .007), IgG2 (1467, 813-2607 vs 1036, 519-2012 μg/mL; P = .01), and GXM-IgG (1:170, 61-412 vs 1:117, 47-176; P = .0009) and lower curdlan-IgG (1:47, 11-133 vs 1:93, 40-206; P = .01) titers. GXM-IgG was associated directly with cryptococcal antigenemia adjusted for CD4 count and antiretroviral therapy use (odds ratio, 1.64; 95% confidence interval [CI], 1.21 to 2.22). Among CrAg-positive individuals, GXM-IgG was inversely associated with mortality at 6 months adjusted for CD4 count and tuberculosis (hazard ratio, 0.50; 95% CI, .33 to .77). Conclusions: The inverse association of GXM-IgG with mortality in CrAg-positive individuals suggests that GXM-IgG titer may have prognostic value in those individuals. Prospective longitudinal studies to investigate this hypothesis and identify mechanisms by which antibody may protect against mortality are warranted. Competing Interests: Potential conflicts of interest. N. P. G. reports grants or contracts from NIH, UK MRC, Gates Foundation, CDC, and NHLS Research Trust (paid to institution); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from the South African HIV Clinicians Society (paid to author); a role as president and council member of FIDSSA; and receipt of equipment, materials, drugs, medical writing, gifts, or other services from Immy– CrAg LFA strips (paid to institution). T. S. H. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Gilead Sciences and Pfizer (paid to author). J. N. J. reports grants from the CDC; speaker fees from Gilead; participation on a data and safety monitoring board as the TSC chair for ASTRO, HARVEST, ARTIST, ACACIA, and CASTLE; and received a drug donation for a clinical trial from Gilead Sciences, Inc. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
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معلومات مُعتمدة: | MC_PC_MR/P006922/1 United Kingdom MRC_ Medical Research Council; MR/V033417/1 United Kingdom MRC_ Medical Research Council; R01 AI143453 United States AI NIAID NIH HHS |
فهرسة مساهمة: | Keywords: GXM-IgG; HIV/AIDS; cryptococcal antigenemia; mortality; serology |
المشرفين على المادة: | 0 (Antigens, Fungal) 0 (Immunoglobulin G) |
تواريخ الأحداث: | Date Created: 20220802 Date Completed: 20230224 Latest Revision: 20240214 |
رمز التحديث: | 20240214 |
مُعرف محوري في PubMed: | PMC10226730 |
DOI: | 10.1093/cid/ciac633 |
PMID: | 35915964 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1537-6591 |
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DOI: | 10.1093/cid/ciac633 |