CLAUDIA PLESCA, CARMEN MANCIUC, EGIDIA MIFTODE, CATALINA LUCA, AIDA BADESCU, OLIVIA DORNEANU, LUMINITA SMARANDA IANCU PREDICTIVE VALUE OF LABORATORY MARKERS IN HIV-POSITIVE PATIENT DIAGNOSED WITH SEVERE SEPSIS Nowadays opportunistic infections are not the only threat in the case of HIV-infected patients, being upstaged by microbial or fungal severe infections, especially after the introduction of ultimate generation antiretroviral therapy. The aim of this study is to investigate the factors that are predictive for an unfavourable prognosis and the causality of severe sepsis in HIV-immuno-depressed hosts. The study included 42 HIV-seropositive patients, found out in the evidence of HIV/AIDS Regional Centre from Iasi, that have been diagnosed with severe sepsis with confirmed etiology between the January 2012 and December 2016. The study group was subdivided in two subgroups: the first batch represented by twenty patients HIV-infected in childhood (pediatric cohort) and the second batch represented by 22 patients HIV-infected in adulthood. The medium age at the time of the sepsis diagnosis was significantly lower in the first group compared to the second one (25.0±2.58 vs 34.9±11.8). The lowest CD4 cells levels were noted in the case of patients infected in childhood, being in C2/C3 disease stage. The bacterial etiology was variate in both studied subgroups, with the predominance of Escherichia coli (33.3%), Staphylococcus aureus meticilino-rezistent (26.2%) and Streptococcus pneumoniae (19%) strains. The liver and kidney disfunctions were frecvently present in HIV-infected patients with severe sepsis (n=28 respectiv 31). A high percentage of patients associated criptocococcosis meningoencephalitis (33.3%), the most affected were those from the second subgroup (40.9%). Systemic infections in HIV-seropositive patients presumes an additional risk of unfavourable outcome, especially in the context of non-adherence and non-compliance to ARV-therapy and a long-term HIV infection history.
Keywords: Severe sepsis, HIV Immunodepression, Antibiotherapy