P-1570. Plasma IL-6 level predict the risk of in-hospital mortality in HIV-associated Pneumocystis Pneumonia

TL;DR

This study shows that higher plasma IL-6 levels in HIV patients with Pneumocystis pneumonia are linked to a higher risk of dying in the hospital.

Contribution

The study identifies plasma IL-6 as a strong predictor of in-hospital mortality in HIV-associated Pneumocystis pneumonia.

Findings

Non-survivors had significantly higher IL-6 levels compared to survivors.

IL-6 had the highest AUC (0.883) for predicting mortality compared to other markers.

Multivariable analysis confirmed IL-6 as a significant predictor of mortality.

Abstract

To determine plasma immune-inflammatory biomarkers that may predict in-hospital mortality in HIV-infected individuals diagnosed with pneumocystis jirovecii pneumonia (PCP).Table 1Characteristics of 125 HIV-infected patients with Pneumocystis pneumonia based on survival outcomesFigure 1Receiver operating characteristic (ROC) curves for in-hospital mortality.IL-6 interleukine-6. The combined ROC curve represents the combination of IL-6 and other markers used to predict in-hospital mortality.

Characteristics of 125 HIV-infected patients with Pneumocystis pneumonia based on survival outcomes

Receiver operating characteristic (ROC) curves for in-hospital mortality.

IL-6 interleukine-6. The combined ROC curve represents the combination of IL-6 and other markers used to predict in-hospital mortality.

This study prospectively included 125 HIV-infected patients with PCP. Biomarkers involving clinical variables and 8 pre-selected plasma inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, IL-2, IL-4, IL-6, IL-10, IL-12, IL-17, TNF-α, and IFN-γ) were evaluated at time of admission. Multivariate logistic regression analysis was used to identify factors substantially associated with in-hospital mortality. The predictive value of the biomarkers for in-hospital mortality was assessed using the ROC curve.

Our results show a hospital mortality rate of 12.8% (16/125). When compared to surviving AIDS PCP patients, non-survivors had substantially higher levels of C-reactive protein, IL-6, aspartate aminotransferase, and lactate dehydrogenase and lower levels of albumin, PO2, and CD4 count. We found a significant association between increased IL-6 levels and hospital mortality using multivariable logistic regression analysis (adjusted odd ratio, 1.006; 95% CI, 1.002-1.012; P = 0.012). The plasma IL-6 levels had a maximum area under the Area Under Curve (AUC) (0.883; 95%CI, 0.812-0.953), compared to CD4+ T cell (AUC, 0.789; 95%CI, 0.697-0.881), ALB (AUC, 0.776; 95%CI, 0.661-0.892), and LDH (AUC, 0.703; 95%CI, 0.573-0.832).

A high level of plasma IL-6 has been associated to an elevated probability of in-hospital mortality.

All Authors: No reported disclosures

Figures