Association Between Soluble Cluster of Differentiation 14 Levels and Active Tuberculosis Infection in Human Immunodeficiency Virus Patients

Abstract

BACKGROUND: Tuberculosis is the major opportunistic infection and the leading cause of death among the HIV population worldwide. Indonesia is included among the countries seriously affected by both TB and HIV. HIV increases the lifetime risk of TB infection. One of the parameters related to TB infection in HIV patients is the level of sCD14, which is part of monocytes and macrophages and can bind to lipoarabinomannan in Mycobacterium tuberculosis. METHODS: This study uses cross-sectional analysis. The research subjects were determined by the purposive consecutive method at the Sanglah Hospital, Bali, in 2021–2022. The sCD14 level was measured by the ELISA method. The diagnosis of active tuberculosis was confirmed by examining patient specimens using the molecular rapid test method RT-PCR GeneXpert MTB/RIF. RESULTS: There were 60 subjects with HIV infection, consisting of 42 (70%) men and 18 (30%) women. The mean age was 39.13 ± 11.734 years. The median body mass index was 18.8 (16.3–23.4), clinical stage 1–2 was 17 (28.3%), and stage 3–4 was 43 (71.7%). A total of 46 (76.7%) people had other opportunistic infections besides TB. The cut-off point for sCD14 levels was 2900 ng/mL. Subjects with active TB infection were 18 (30%) people and 42 (70%) people without TB. The results of bivariate analysis using the Chi-Square test found a significant relationship between sCD14 levels and active tuberculosis infection in HIV patients (p < 0.001). Multivariate analysis with logistic regression showed that high sCD14 levels were independently associated with active tuberculosis infection in HIV patients (AOR 13.64; 95% CI: 2.89–64.42; p = 0.001), while other confounding factors were not significantly associated with active tuberculosis infection in HIV patients. CONCLUSION: sCD14 levels are associated with active tuberculosis infection in HIV patients.