Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.

<h4>Background</h4>Pneumocystis jirovecii remains an important cause of fatal pneumonia (Pneumocystis pneumonia or PcP) in HIV+ patients and other immunocompromised hosts. Despite many previous attempts, a clinically useful serologic test for P. jirovecii infection has never been develop...

Full description

Bibliographic Details
Main Authors: Kpandja Djawe, Laurence Huang, Kieran R Daly, Linda Levin, Judy Koch, Alexandra Schwartzman, Serena Fong, Brenna Roth, Anuradha Subramanian, Katherine Grieco, Leah Jarlsberg, Peter D Walzer
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2010-12-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21151564/?tool=EBI
id doaj-1c8b57672d734c17babfa638bf66db25
record_format Article
spelling doaj-1c8b57672d734c17babfa638bf66db252021-03-04T02:12:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032010-12-01512e1425910.1371/journal.pone.0014259Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.Kpandja DjaweLaurence HuangKieran R DalyLinda LevinJudy KochAlexandra SchwartzmanSerena FongBrenna RothAnuradha SubramanianKatherine GriecoLeah JarlsbergPeter D Walzer<h4>Background</h4>Pneumocystis jirovecii remains an important cause of fatal pneumonia (Pneumocystis pneumonia or PcP) in HIV+ patients and other immunocompromised hosts. Despite many previous attempts, a clinically useful serologic test for P. jirovecii infection has never been developed.<h4>Methods/principal findings</h4>We analyzed serum antibody responses to the P. jirovecii major surface glycoprotein recombinant fragment C1 (MsgC1) in 110 HIV+ patients with active PcP (cases) and 63 HIV+ patients with pneumonia due to other causes (controls) by an enzyme-linked immunosorbent assay (ELISA). The cases had significantly higher IgG and IgM antibody levels to MsgC1 than the controls at hospital admission (week 0) and intervals up to at least 1 month thereafter. The sensitivity, specificity and positive predictive value (PPV) of IgG antibody levels increased from 57.2%, 61.7% and 71.5% at week 0 to 63.4%, 100%, and 100%, respectively, at weeks 3-4. The sensitivity, specificity and PPV of IgM antibody levels rose from 59.7%, 61.3%, and 79.3% at week 0 to 74.6%, 73.7%, and 89.8%, respectively, at weeks 3-4. Multivariate analysis revealed that a diagnosis of PcP was the only independent predictor of high IgG and IgM antibody levels to MsgC1. A high LDH level, a nonspecific marker of lung damage, was an independent predictor of low IgG antibody levels to MsgC1.<h4>Conclusions/significance</h4>The results suggest that the ELISA shows promise as an aid to the diagnosis of PCP in situations where diagnostic procedures cannot be performed. Further studies in other patient populations are needed to better define the usefulness of this serologic test.https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21151564/?tool=EBI
collection DOAJ
language English
format Article
sources DOAJ
author Kpandja Djawe
Laurence Huang
Kieran R Daly
Linda Levin
Judy Koch
Alexandra Schwartzman
Serena Fong
Brenna Roth
Anuradha Subramanian
Katherine Grieco
Leah Jarlsberg
Peter D Walzer
spellingShingle Kpandja Djawe
Laurence Huang
Kieran R Daly
Linda Levin
Judy Koch
Alexandra Schwartzman
Serena Fong
Brenna Roth
Anuradha Subramanian
Katherine Grieco
Leah Jarlsberg
Peter D Walzer
Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
PLoS ONE
author_facet Kpandja Djawe
Laurence Huang
Kieran R Daly
Linda Levin
Judy Koch
Alexandra Schwartzman
Serena Fong
Brenna Roth
Anuradha Subramanian
Katherine Grieco
Leah Jarlsberg
Peter D Walzer
author_sort Kpandja Djawe
title Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
title_short Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
title_full Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
title_fullStr Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
title_full_unstemmed Serum antibody levels to the Pneumocystis jirovecii major surface glycoprotein in the diagnosis of P. jirovecii pneumonia in HIV+ patients.
title_sort serum antibody levels to the pneumocystis jirovecii major surface glycoprotein in the diagnosis of p. jirovecii pneumonia in hiv+ patients.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2010-12-01
description <h4>Background</h4>Pneumocystis jirovecii remains an important cause of fatal pneumonia (Pneumocystis pneumonia or PcP) in HIV+ patients and other immunocompromised hosts. Despite many previous attempts, a clinically useful serologic test for P. jirovecii infection has never been developed.<h4>Methods/principal findings</h4>We analyzed serum antibody responses to the P. jirovecii major surface glycoprotein recombinant fragment C1 (MsgC1) in 110 HIV+ patients with active PcP (cases) and 63 HIV+ patients with pneumonia due to other causes (controls) by an enzyme-linked immunosorbent assay (ELISA). The cases had significantly higher IgG and IgM antibody levels to MsgC1 than the controls at hospital admission (week 0) and intervals up to at least 1 month thereafter. The sensitivity, specificity and positive predictive value (PPV) of IgG antibody levels increased from 57.2%, 61.7% and 71.5% at week 0 to 63.4%, 100%, and 100%, respectively, at weeks 3-4. The sensitivity, specificity and PPV of IgM antibody levels rose from 59.7%, 61.3%, and 79.3% at week 0 to 74.6%, 73.7%, and 89.8%, respectively, at weeks 3-4. Multivariate analysis revealed that a diagnosis of PcP was the only independent predictor of high IgG and IgM antibody levels to MsgC1. A high LDH level, a nonspecific marker of lung damage, was an independent predictor of low IgG antibody levels to MsgC1.<h4>Conclusions/significance</h4>The results suggest that the ELISA shows promise as an aid to the diagnosis of PCP in situations where diagnostic procedures cannot be performed. Further studies in other patient populations are needed to better define the usefulness of this serologic test.
url https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21151564/?tool=EBI
work_keys_str_mv AT kpandjadjawe serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT laurencehuang serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT kieranrdaly serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT lindalevin serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT judykoch serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT alexandraschwartzman serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT serenafong serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT brennaroth serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT anuradhasubramanian serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT katherinegrieco serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT leahjarlsberg serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
AT peterdwalzer serumantibodylevelstothepneumocystisjiroveciimajorsurfaceglycoproteininthediagnosisofpjiroveciipneumoniainhivpatients
_version_ 1714808854512926720