G.R. KHASANOVA^1,2, V.A. ANOKHIN¹, F.I. NAGIMOVA²

Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012

Republican Center of AIDS and Infectious Diseases of Ministry of Healthcare of Tatarstan Republic, 2a Vishnevskogo St., Kazan, Russian Federation, 420097 

Khasanova G.R. — Associated Professor of the Department of Pediatric Infectious Diseases, ID specialist, tel. (843) 267-8006, e-mail: gulshatra@mail.ru¹

Anokhin V.A. — D. Med. Sc., Professor, Head of the Department of Pediatric Infectious Diseases, (843) 267-8100, e-mail:anokhin56@mail.ru¹

Nagimova F.I. — Cand. Med. Sc., Vice-Head of the Center of AIDS and Infectious Diseases of Ministry of Health of Tatarstan Republic, tel. (843) 236-9436, e-mail: nagimova@list.ru²

Chronic activation of inflammation is an important cause of HIV-infection progression. Endotoxin of gram-negative micro organisms is one of the possible agents which cause systemic inflammation. The purpose of our research was to evaluate the prognostic value of sCD14 — the marker of endotoxin-induced activation of cells — in the HIV-infection progression. A prospective cohort study was done to assess dynamics of CD4+ cells. 89 patients were divided into 2 groups, depending on the level of sCD14 (≤2.94 or >2.94 pg/ml). The increased level of sCD14 during the whole course of disease was detected. The level of sCD14 in HIV-group was higher than the level in control group [2.95 pg/ml (95%CI 2.45-3.63) and 1.91 pg/ml (95%CI 1.67-2.22) respectively, р=0.00001]. Correlations of sCD14 and markers of inflammation were found, such as: tumor necrosis factor-α (r=0.35; p=0.007), leucocytes number (r=0.21; p=0.04) and erythrocyte sedimentation rate (r=0.27; p=0.013). Correlation of sCD14 level with markers of progression of HIV-infection was detected, such as: stage of the disease (r=0.41; p=0.00006; presence of opportunistic infections (r=0.41; p=0.00006), decrease of CD4-cells (r=-0.21; p=0.046). The analysis of results of cohort study revealed that higher levels of sCD14 predict higher speed of depletion of CD4+cells in patients without antiretroviral treatment, as well as higher rate of «lack of response» to treatment. Prognostic value of sCD14 levels in HIV-infection progression confirms the role of endotoxin of gram-negative micro organisms and the value of microbial translocation in the HIV-infection pathogenesis.

Кey words: HIV-infection, sCD14, endotoxin, inflammation.

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