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

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.