Abstract:
Objective To understand the pathogen spectrum causing complicated pulmonary infections in human immunodeficiency virus （HIV） infection cases at different immune levels and provide evidnce for the precise diagnosis, treatment, and prevention of HIV infection cases.
Methods Bronchoalveolar lavage fluid samples from 50 HIV infection cases complcated with pulmonary infection, admitted to Beijing Ditan Hospital, Capital Medical University between July 2021 and January 2022, were used for pathogen detection with metagenomic next-generation sequencingtechnology （mNGS）. The study analyzed the correlation between the identified pathogens and CD4+ T cells.
Results The mNGS analysis found 33 bacterial species, in which stenotrophomonas maltophilia was predominat, 5 fungal species, in which Pneumocystis jirovecii was predomiant, and 5 DNA viruses, in which cytomegalovirus was most frequently detected. The study identified a correlation between the HIV co-infection pathogen spectrum and CD4+ T cell count （Mantel test, r > 0.2, P < 0.05）, P. aeruginosa was mainly detected when CD4+ T cell count was ≥350 cells/μL, P. jirovecii was mainly detected when CD4+ T cell count ranged from 350 to 200 cells/μL, and Staphylococcus aureus, Mycobacterium tuberculosis and other opportunistic infection pathogens were detected when CD4+ T cell count was <200 cells/μL.
Conclusion Pathogen specturm varied with immune status in HIV infection cases complicated with pulmonary infection. This study described the characteristis of pathogen specturm causing complicated pulmonary infection in HIV infection cases and analyze the influence of immunue status on the detection of pathogen, indiating the importance of etiological diagnosis in clinical management.
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