NOVEL KIDNEY, ENDOTHELIAL, AND INFLAMMATORY BIOMARKERS IN AIDS-ASSOCIATED DISSEMINATED HISTOPLASMOSIS

 

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NOVEL KIDNEY, ENDOTHELIAL, AND INFLAMMATORY BIOMARKERS IN AIDS-ASSOCIATED DISSEMINATED HISTOPLASMOSIS

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Elizabeth
De Francesco Daher
Matheus Alves de Lima Mota matheusmot@gmail.com Federal University of Ceara Medical Sciences Graduate Program Fortaleza Brazil - Sao Jose Infectious Diseases Hospital Division of Infectious Diseases Fortaleza Brazil
Katarina Maria dos Reis Araújo katarinamreis@gmail.com Federal University of Ceara Department of Clinical and Toxicological Analyses Fortaleza Brazil -
Valeria Holanda Holanda Nogueira de Aquino mdvaleria@gmail.com Federal University of Ceara Department of Clinical and Toxicological Analyses Fortaleza Brazil -
Alice Maria Costa Martins martinsalice@gmail.com Federal University of Ceara Department of Clinical and Toxicological Analyses Fortaleza Brazil -
Zayra Hellen de Abreu Alexandre zaydl@hotmail.com Sao Jose Infectious Diseases Hospital Division of Infectious Diseases Fortaleza Brazil -
Geraldo Bezerra da Silva Junior geraldobsilvajr@yahoo.com University of Fortaleza Medical Sciences and Public Health Graduate Programs Fortaleza Brazil -
Gdayllon Cavalcante Meneses gdayllon@yahoo.com Federal University of Ceara Department of Clinical and Toxicological Analyses Fortaleza Brazil -
Elizabeth De Francesco Daher ef.daher@uol.com.br Federal University of Ceara Medical Sciences Graduate Program Fortaleza Brazil *
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Disseminated histoplasmosis (DH) is a severe opportunistic infection in people living with HIV/AIDS (PLWHA). This study aims to investigate novel biomarkers: neutrophil gelatinase–associated lipocalin (NGAL), vascular cell adhesion molecule-1 (VCAM-1), syndecan-1, angiopoietin-1 (Ang-1), Ang-2, and interleukin-6 (IL-6) in PLWHA with DH.

This is a cross-sectional study comparing the concentrations of kidney, endothelial, and inflammatory biomarkers in three groups: (I) PLWHA with DH; (II) PLWHA without DH; and (III) HIV-negative healthy controls. HIV infection was confirmed using a fourth-generation immunoassay, followed by a rapid immunoblot. Proven DH was defined as the direct visualization or culture isolation of H. capsulatum in the peripheral blood, buffy coat, bone marrow aspirate, or another sterile site. Biomarkers’ analyses were conducted at the Laboratory of Pharmaceutical Bioprospecting and Clinical Biochemistry, affiliated with the Federal University of Ceara, Brazil.

A total of 67 participants were enrolled: 34 PLWHA with DH, 13 PLWHA without DH, and 20 healthy controls. The cohort was predominantly male (74.6%) with a mean age of 35.9 ± 10.9 years. No significant differences were observed between the HIV groups regarding age, sex, CD4+ T-cell counts, or HIV viral load. Serum creatinine levels differed significantly among the three groups (p = 0.011), and post hoc analysis revealed higher values in PLWHA with DH than in those without DH (p = 0.024). Urea and IL-6 were measured only in the HIV groups, with significant differences observed (p = 0.001 and p < 0.001, respectively), and NGAL was measured only in the HIV with DH group and in healthy controls. Post hoc analyses were conducted for biomarkers with data available in all three groups. VCAM-1 and Syndecan-1 levels were higher in PLWHA with DH than in healthy controls and PLWHA without DH (all p < 0.001). For Ang-1, differences were observed between healthy controls and PLWHA without DH (p = 0.002) and between healthy controls and PLWHA with DH (p < 0.001). For Ang-2, significant differences were found between healthy controls and PLWHA without DH (p = 0.022) and between healthy controls and PLWHA with DH (p = 0.002).

PLWHA with DH exhibited significant alterations in these biomarkers, suggesting a potential role for Histoplasma capsulatum in kidney and endothelial dysfunction.

Kewords