Deficiency of mannose-binding lectin is a risk of Pneumocystis jirovecii pneumonia in a natural history cohort of people living with HIV/AIDS in Northern Thailand

Kunio Yanagisawa, Nuanjun Wichukchinda, Naho Tsuchiya, Michio Yasunami, Archawin Rojanawiwat, Hidenori Tanaka, Hiroh Saji, Yoshiyuki Ogawa, Hiroshi Handa, Panita Pathipvanich, Koya Ariyoshi, Pathom Sawanpanyalert

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Mannose-binding lectin (MBL) plays a pivotal role in innate immunity; however, its impact on susceptibility to opportunistic infections (OIs) has not yet been examined in a natural history cohort of people living with HIV/AIDS. Methods: We used archived samples to analyze the association between MBL expression types and risk of major OIs including Pneumocystis jirovecii pneumonia (PCP), cryptococcosis, talaromycosis, toxoplasmosis, and tuberculosis in a prospective cohort in Northern Thailand conducted from 1 July 2000 to 15 October 2002 before the national antiretroviral treatment programme was launched. Results: Of 632 patients, PCP was diagnosed in 96 (15.2%) patients, including 45 patients with new episodes during the follow-up period (1006.5 person-years). The total history of PCP was significantly associated with low MBL expression type: high/intermediate (81/587, 13.8%), low (10/33, 30.3%) and deficient (5/12, 41.7%) (p = 0.001), whereas the history of other OIs showed no relation with any MBL expression type. Kaplan-Meier analysis (n = 569; log-rank p = 0.011) and Cox's proportional hazards model revealed that deficient genotype dramatically increased the risk of PCP, which is independent upon sex, age, CD4 count, HIV-1 viral load and hepatitis B and C status (adjusted hazard ratio 7.93, 95% confidence interval 2.19- 28.67, p = 0.002). Conclusions: Deficiency of MBL expression is a strong risk factor determining the incidence of PCP but not other major OIs.

Original languageEnglish
Article numbere0242438
JournalPloS one
Volume15
Issue number12 December
DOIs
Publication statusPublished - 2020 Dec

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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