Chlamydia pneumoniae infection in HIV‐positive patients: prevalence and relationship with lipid profile

Abstract

The aims of this study were to evaluate the prevalence and impact of Chlamydia pneumoniae infection in HIV-positive patients and to establish the relationship between C. pneumoniae infection and lipid profile. MethodsDetection of C. pneumoniae was by polymerase chain reaction (PCR) on Peripheral Blood Mononuclear Cells (PBMCs) collected from 97 HIV-positive patients. Samples were collected after overnight fast in EDTA-treated tubes. On the same day, patients were also tested for routine chemistry, HIV viral load, CD3, CD8 and CD4 cell counts and lipid profile [cholesterol, high-density lipoproteins (HDLs), low-density lipoproteins (LDLs) and triglycerides]. ResultsThe overall prevalence of C. pneumoniae was 39%. The prevalence of C. pneumoniae was inversely related to the CD4 lymphocyte count (P 5 0.03). In the naive group, C. pneumoniae-positive patients had both significantly higher HIV load (71 021 AE 15 327 vs. 14 753 AE 14 924 HIV-1 RNA copies/mL; P 5 0.03) and lower CD4 cell count (348.0 AE 165.4 vs. 541.7 AE 294.8; P 5 0.04) than C. pneumoniaenegative patients. Moreover, treatment-naive patients with C. pneumoniae infection had significantly higher mean levels of cholesterol (185.3 AE 56.2 vs. 124.8 AE 45.9 mg/dL; P 5 0.01), triglycerides (117.2 AE 74.7 vs. 68 AE 27.6 mg/dL; P 5 0.04) and LDL (122.4 AE 60.1 vs. 55.6 AE 58 mg/ dL; P 5 0.05) than C. pneumoniae-negative patients. ConclusionsThese data indicate that, in HIV-positive subjects, C. pneumoniae infection is relatively frequent and is associated with both low CD4 cell count and high HIV load. Furthermore, C. pneumoniae appears to be associated with hyperlipidaemia and might therefore represent a further risk factor for cardiovascolar disease in HIV-positive patients.Keywords: AIDS, Chlamydia pneumoniae, cholesterol, HDL, HIV, LDL, triglycerides IntroductionThe prevalence and effects of Chlamydia pneumoniae infection have been extensively evaluated both in the normal population and in patients with cardiovascular disease [1][2][3][4]. It has emerged that chronic C. pneumoniae infection could represent a cofactor involved in the pathogenesis of atherosclerosis [5][6][7]. C. pneumoniae may also affect lipid metabolism [8][9][10][11]. These findings are of particular interest in HIV-positive subjects on highly active antiretroviral therapy (HAART), as an increase in lipid levels, mainly characterized by hypertriglyceridaemia and hypercholesterolaemia which are generally considered risk factors for coronary heart disease, has been reported in these patients [12,13]. Furthermore, the incidence of cardiovascular disease in HIV-infected patients treated with HAART has been increasing [14][15][16][17] [18][19][20]. These are important findings, because a reciprocal interaction between HIV and C. pneumoniae may be hypothesized to occur either in immune system cells or in endothelial cells.The aims of this study were to evaluate the prevalence and effects of C. pneumoniae infection on immunological and virological parameters in HIV-positive patients, and to ...

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