The newest and classic biomarkers of sepsis in HIV-infected adult patients

Abstract

Sepsis is one of the major causes of mortality of patients worldwide, and patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) are at higher risk of developing it. Given the importance of quick diagnosis, the demand for sepsis biomarkers is high. In this article, the authors reviewed the available sepsis biomarkers, and assessed whether the biomarkers were analyzed in patients with HIV/AIDS. We investigated the available literature on classic inflammatory biomarkers, such as procalcitonin (PCT) and interleukin-6 (IL-6) as well as new biomarkers of sepsis, including soluble form of urokinase-type plasminogen activator receptor (suPAR), proadrenomedullin (proADM), soluble triggering receptor expressed on myeloid cells 1 (sTREM-1), growth arrest-specific 6 (Gas6), and microRNA (miRNA) in immunocompetent patients and patients living with HIV/AIDS. Various biomarkers have a diagnostic value (PCT, sTREM-1), others present a prognostic value (suPAR, Gas6, PSP, HBP), and some biomarkers have both values (IL-6, proADM, sCD14-ST, miRNA). Combining at least two different biomarkers has the best potential to bring high sensitivity and specificity of diagnosis. To our knowledge, many of discussed novel inflammatory biomarkers, such as presepsin, pancreatic stone protein/regenerating protein (PSP/reg), or heparin-binding protein (HBP), were not yet studied in a population of patients with HIV/AIDS and sepsis. So far, there is not a one biomarker used as a golden standard in diagnosis of sepsis. Monitoring at least two biomarkers might increase the chance of early detection of sepsis. Further research is needed to find biomarkers diagnosing sepsis in patients with AIDS.