Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study

BMC Infectious Diseases

Research Article

Alessandra Bandera¹  Nicoletta Ladisa²  Massimo di Pietro³  Laura Sighinolfi³  Chiara Fornabaio⁴  Franco Maggiolo⁵  Filippo Castelnuovo⁶  Simona Digiambenedetto⁷  Francesco Donato⁸  Elena Raffetti⁸  Salvatore Casari⁹  Eugenia Quiros-Roldan⁹ 

[1] Clinic of Infectious Diseases, San Gerardo de’ Tintori Hospital, Monza, Italy;Clinic of Infectious Diseases, University of Bari, Bari, Italy;Clinical Infectious Diseases of “Azienda Ospedaliera S. Anna” of Ferrara, Ferrara, Italy;Clinical Infectious Diseases of “Istituti Ospitalieri” of Cremona, Cremona, Italy;Clinical Infectious Diseases of “Ospedale Papa Giovanni XXIII” of Bergamo, Bergamo, Italy;Hospital Division of Infectious and Tropical Diseases, Spedali Civili General Hospital, Brescia, Italy;Institute of Clinical Infectious Diseases of Catholic University of Rome, Rome, Italy;Unit of Hygiene, Epidemiology and Public Health, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy;University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy;

关键词: Neutrophil to lymphocyte ratio;    Platelet to lymphocyte ratio;    Mortality for all-causes;    Inflammation;   

DOI  :  10.1186/s12879-017-2280-5

 received in 2016-04-15, accepted in 2017-02-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTwo biomarkers, the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been shown to be indicative of systemic inflammation and predictive of mortality in general population. We aimed to assess the association of NLR and PLR, with risk of death in HIV-infected subjects when also taking account of HIV-related factors.MethodsWe conducted a multicenter Italian cohort study from 2000 to 2012 including HIV-infected subjects naïve at antiretroviral treatment.The associations of NLR and PLR with all-cause mortality were tested by univariate and multivariate analyses using both time independent and dependent Cox proportional hazard models. We also fitted models with a cubic-spline for PLR and NLR to evaluate the possible non-linear relationship between biomarkers values and risk of death.ResultsEight-thousand and two hundred thirty patients (73.1% males) with a mean age of 38.4 years (SD 10.1) were enrolled. During a median follow-up of 3.9 years, 539 patients died. PLR < 100 and ≥ 200, as compared to PLR of 100–200, and NLR ≥ 2, as compared to < 2, were associated with risk of death at both univariate and multivariate analyses. Using multivariate models with restricted cubic-splines, we found a linear relationship of increasing risk of death with increasing values for NRL over 1.1, and an U-shape curve for PLR, with higher mortality risk for values higher or lower than 120.ConclusionsOur data suggest that NLR and PLR can reflect the severity of the underlying systemic disturbance of the inflammatory process and coagulation leading to augmented mortality in HIV positive subjects.

【 授权许可】

CC BY   
© The Author(s). 2017