Journal Article

Diagnostic value of Serum Amyloid A (SAA) in HIV-associated pulmonary infections and its correlation with inflammatory markers

Tang, Haicheng, Wu, Qingguo, Chen, Ruifang, Ren, Shuai

2025

Overview

Objective To evaluate the impact of Human Immunodeficiency Virus (HIV) infection on serum amyloid A (SAA) levels in acute pulmonary infections and assess correlations between SAA and other inflammatory markers in HIV-associated pneumonia. Methods In this retrospective case-control study, 48 HIV-positive patients with pulmonary infections (HIV group) and 55 age-matched HIV-negative controls (control group) were enrolled from Shanghai Public Health Clinical Center (2021.5–2025.5). Demographic, hospitalization duration and laboratory parameters - including SAA, white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), platelet count (PLT), CD4 + T cell count, and absolute lymphocyte count(ALC) - were systematically collected from both patient cohorts. For intergroup comparisons, the Mann-Whitney U test was employed, while Spearman’s rank correlation analysis was conducted to assess biomarker associations within the HIV-positive subgroup. Results Among 103 patients, the HIV group had higher male predominance (83.3% vs. 54.5%, P  = 0.02) and lower CD4 + T cell count (215.17 vs. 443.41 cells/µL, P  < 0.05). SAA (178.39 vs. 122.93 mg/L, P  = 0.032), CRP (64.27 vs. 37.07 mg/L, P  = 0.031), LDH (310.65 vs. 235.96 U/L, P  = 0.024), and hospitalization duration (16.83 vs. 13.05 days, P  = 0.013) were significantly elevated in HIV patients. SAA correlated positively with CRP ( r  = 0.4807), PCT ( r  = 0.3554), LDH ( r  = 0.3564), and PLT ( r  = 0.3094) ( P  < 0.05 for all). Conclusions Patients with HIV-associated pulmonary infections exhibited significantly elevated levels of SAA, CRP, and LDH, along with prolonged hospital stays, compared to non-HIV-infected individuals. These findings suggest that HIV infection amplifies systemic inflammatory responses, potentially contributing to extended hospitalization. The robust correlations between SAA and other biomarkers (including CRP, PCT, LDH, PLT) highlight its potential as a key component in early diagnostic panels for HIV-associated pulmonary infections.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Amyloid / Analysis / Antiviral agents / Bacterial pneumonia / Biomarkers / Biomarkers - blood / C-reactive protein / C-Reactive Protein - analysis / Care and treatment / Case-Control Studies / CD4 antigen / CD4 Lymphocyte Count / Cell number / Chronic illnesses / Correlation analysis / Cutting-edge diagnostics for infectious diseases: emerging technologies and approaches / Cytokines / Diagnosis / Diagnostic accuracy / Dosage and administration / Female / HIV / HIV Infections - blood / HIV Infections - complications / HIV patients / HIV testing / Hospitalization / Human immunodeficiency virus / Humans / Immune system / Infections / Infectious Diseases / Inflammation / Inflammation - blood / Inflammatory markers / Internal Medicine / L-Lactate dehydrogenase / Lactate dehydrogenase / Leukocytes / Lymphocytes / Lymphocytes T / Male / Medical Microbiology / Medicine / Medicine & Public Health / Middle Aged / Parasitology / Pathogens / Patients / Pneumonia / Pneumonia - blood / Pneumonia - diagnosis / Procalcitonin / Procalcitonin - blood / Public health / Pulmonary infection / Retrospective Studies / Risk factors / Serum Amyloid A (SAA) / Serum Amyloid A Protein - analysis / Subgroups / Tropical Medicine