PNEUMOCYSTIS-CARINII PNEUMONIA IN HIV-INFECTED PATIENTS - EFFECTS OF THE DISEASES ON GLUTATHIONE AND GLUTATHIONE DISULFIDE

Human immunodeficiency virus (HIV) infection is associated with altere d levels of glutathione (GSH) in cells and extracellular fluids. GSH i s essential for lymphocyte proliferation and inhibits HIV replication. Therefore, determination of GSH and glutathione disulfide (GSSG) leve ls could be useful as indicators of the progression of the disease. Th yroid hormone levels are altered in acquired immuno-deficiency syndrom e (AIDS), such that thyroid hormone might be a useful prognostic indic ator of the severity of AIDS. Pneumocystis carinii pneumonia (PCP) is a debilitating disease of the lung that can accompany HIV infection. T he effects of pulmonary infections were assessed in AIDS patients on t hyroid hormone, GSH, GSSG levels and other parameters. Two groups of A IDS patients were selected, a group with PCP and a control group with other respiratory diseases. GSH was evaluated in plasma, pulmonary lav age fluid, pulmonary biopsy tissue and buccal cells. Levels of GSSG in pulmonary lavage fluid were higher in PCP patients than in controls, which suggests that PCP patients suffer from oxygen radical toxicity i n their lungs. PCP patients may have altered plasma GSH utilization su ch that damaged lung tissue may become less efficient at using plasma GSH. Patients with PCP may have altered CD4 cell functions such that t hyroid hormone levels do not correlate with CD4 cell counts. Patients with AIDS and secondary infections of the lung were found to have alte red GSH redox states, probably indicative of physiologic adaptation to AIDS.