Faecal Calprotectin in HIV‐infected, HAART‐naïve Ugandan Children

Hestvik, Elin; Olafsdottir, E; Tylleskär, Thorkild; Aksnes, Lage; Kaddu-Mulindwa, Deogratias H; Ndeezi, Grace; Tumwine, James; Grahnquist, Lena

doi:10.1097/mpg.0b013e318241a683

Cited by 17 publications

(17 citation statements)

References 138 publications

(242 reference statements)

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“…Our results differ from those of Gori et al who found high levels of fecal calprotectin in 27 of 53 HIV-naïve patients, and from those of Hestvik et al who reported a median fecal calprotectin concentration above the reference value in HIV-infected HAART-naïve children in Uganda 3,15. Hestvik et al also demonstrated increased fecal calprotectin concentration in children with more advanced disease 15.…”

Section: Discussioncontrasting

confidence: 99%

“…Hestvik et al also demonstrated increased fecal calprotectin concentration in children with more advanced disease 15. However, both of these studies considered only HIV HAART-naïve patients, did not take into account whether their patients had symptoms of organic disease, and did not exclude other causes of inflammation by fecal or blood analysis.…”

Section: Discussionmentioning

confidence: 99%

“…High levels of fecal calprotectin, a calcium-binding and zinc-binding protein, abundant in neutrophils and found in monocytes/macrophages, correlate strongly with mucosal inflammation of the gut 2,14,15. Recent studies have demonstrated a rise in fecal calprotectin in untreated HIV-infected children.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have demonstrated a rise in fecal calprotectin in untreated HIV-infected children. Gori et al found high levels of fecal calprotectin in 27 of 53 HIV-naïve patients,3 and Hestvik et al showed a median fecal calprotectin concentration above the reference value in HIV-infected, HAART-naïve children in Uganda 15. Bowel ultrasound is a well-established method for assessment of direct and indirect signs of gut inflammation, such as increased wall thickness, mesenteric hypertrophy, and enlarged mesenteric lymph nodes, in inflammatory bowel disease 16.…”

Section: Introductionmentioning

confidence: 99%

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Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Mantegazza

Maconi

Giacomet

et al. 2014

HIV

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BackgroundThe gastrointestinal tract is a primary target for human immunodeficiency virus (HIV). HIV infection causes a depletion of CD4+ T-lymphocytes in gut-associated lymphoid tissue and affects gastrointestinal mucosal integrity and permeability. The gastrointestinal tract has also been suggested as the main reservoir of HIV despite highly active antiretroviral therapy (HAART). We performed a prospective case-control study to assess gut involvement in HIV-infected patients, either naïve or on HAART, using noninvasive methods such as bowel ultrasound and fecal calprotectin.MethodsThirty HIV-infected children and youth underwent the following tests: CD4+ T-cell count and HIV viral load, fecal calprotectin, and bowel ultrasound, with the latter evaluating bowel wall thickness and mesenteric lymph nodes. Fecal calprotectin and bowel ultrasound were also assessed in 30 healthy controls matched for age and sex. Fecal calprotectin was measured using a quantitative immunochromatographic point-of-care test, and concentrations ranging from 0 to 200 μg/g were considered to be normal reference values in children.ResultsFecal calprotectin was normal in 29 HIV-infected patients and was not significantly different from controls (mean values 63.8±42.5 μg/g and 68.3±40.5 μg/g, respectively; P=0.419), and did not correlate with HIV viral load, CD4+ T-cell absolute count and percentage, or HAART treatment. No significant changes were found on bowel ultrasound except for enlarged mesenteric lymph nodes, which were observed in seven HIV-infected patients (23.3%) and two controls (6.6%). This finding was significantly correlated with high HIV viral load (P=0.001) and low CD4+ T-cell percentage (P=0.004).ConclusionHIV-infected children did not have significant biochemical or ultrasonographic signs of bowel inflammation. A few patients showed enlarged mesenteric lymph nodes, which correlated with uncontrolled HIV infection.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Mantegazza

Maconi

Giacomet

et al. 2014

HIV

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“…Mean ± SD plasma calprotectin was significantly increased (p < 0.0001) in obese (131.4 ± 63.7 µg/L) compared with non-obese subjects (102.8 ± 71.7 µg/L). 82 Hestvik et al 86 determined reference values for children infected with HIV and undertaking highly active antiretroviral therapy for the first time. Median FC was 208 µg/g in infants 0 to 1 year, 171 µg/g among toddlers 1 to 4 years, and 62 µg/g for children 4 to 12 years, while also noticing that children with advanced disease and a low CD4 cell percentage had significantly higher median (range) FC concentrations, 203 (143-277) µg/g than those with a high CD4 cell percentage 99 (62-154) µg/g (p < 0.05).…”

Section: Applications In Other Diseasesmentioning

confidence: 99%

Calprotectin: Clinical Applications in Pediatrics

Herrera

Christensen

Helms

2016

The Journal of Pediatric Pharmacology and Therapeutics

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As seen over the past 20 years, calprotectin has evolved as a novel, non-invasive biomarker of gastrointestinal (GI) inflammation. We present this review of calprotectin in pediatrics. This article will focus on studies using calprotectin concentrations from different body fluids to monitor inflammation in different disease states and conditions. The ultimate goal of our group is to lay down a foundation as we consider using calprotectin prospectively as a marker of intestinal inflammation that could lead to further testing and possibly a marker of preparedness for feeding. We surveyed all published studies in English of calprotectin in neonates, infants, children, and adolescents through February 2014. We will discuss calprotectin's basic properties and analysis such as characteristics, identification, presence in body fluids, and maturational development. In addition, calprotectin's use in inflammatory diseases exploring both GI and non-GI conditions will be evaluated and compared with other serum markers presently available. Finally, a summary of our findings and discussion of future work that could be undertaken in order to render calprotectin as a more useful monitoring tool to the medical research community will complete the review.

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Fecal Calprotectin Is Elevated in HIV and Related to Systemic Inflammation

Eckard

Hughes

Hagood

et al. 2021

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Fecal calprotectin (FC), a biomarker of gastrointestinal (GI) inflammation, is used in the diagnosis and management of inflammatory bowel disease. HIV infection severely damages gut-associated lymphoid and epithelial tissues leading to GI inflammation that drives systemic inflammation and increases subsequent risk of comorbidities. For the first time, we compared FC concentrations by HIV and antiretroviral therapy (ART) status and determined the relationship to systemic inflammation. Methods: People with and without HIV were enrolled and underwent a comprehensive clinical and laboratory assessment. Stool samples were collected, and FC was measured by enzyme-linked immunosorbent assay ELISA. Plasma biomarkers of inflammation were also measured. Results: One hundred one participants with HIV (83 ART-treated and 18 ART-naive) and 89 uninfected controls were enrolled. There were no significant differences between ART-naive and ART-treated participants, but both HIV groups had significantly higher FC concentrations than controls when FC was considered as a continuous variable or by cut-offs used in inflammatory bowel disease. The highest median and largest proportion of participants with FC >100 µg/g were seen in ART-naive, followed by ART-treated and then controls. Among HIV participants, FC concentrations were positively associated with high-sensitivity C-reactive protein, soluble tumor necrosis factor receptor II, and soluble vascular cellular adhesion molecule and inversely associated with CD4 counts. Conclusions: FC concentrations are elevated in HIV regardless of ART status. ART and immune reconstitution seem to reduce FC but not to concentrations seen in uninfected controls. Our results suggest a role for FC as a noninvasive surrogate measurement of GI inflammation and associated systemic inflammation in HIV.

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Faecal Calprotectin in HIV‐infected, HAART‐naïve Ugandan Children

Abstract: HIV-infected children older than 4 years had a median FC concentration above the reference value, and gut inflammation in the children with elevated values is likely. Children with more advanced disease had increased FC concentrations regardless of age.

Cited by 17 publications

References 138 publications

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Calprotectin: Clinical Applications in Pediatrics

Fecal Calprotectin Is Elevated in HIV and Related to Systemic Inflammation

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