Commonly Drawn Immunologic and Inflammatory Markers as Risk Predictors for Anal Cancer in Veterans Living With HIV

Area of Science:

• Oncology
• Immunology
• HIV Medicine

Background:

• People living with HIV (PLWH) have an increased risk of anal cancer.
• Immune inflammatory markers may play a role in anal cancer development.
• Identifying reliable biomarkers is crucial for early detection and prevention in PLWH.

Purpose of the Study:

• To investigate the correlation between immune inflammatory markers (NLR, PLR, PNI, CD4/CD8 ratio) and anal cancer risk in veterans with HIV.
• To compare the predictive value of these markers against the CD4/CD8 ratio for anal cancer risk.

Main Methods:

• Retrospective cohort study of veterans with HIV screened for or diagnosed with anal neoplasia/cancer (2001-2019).
• Calculation of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), prognostic nutritional index (PNI), and CD4/CD8 ratio within one year of anal pathology results.
• Multivariate logistic regression modeling to assess the association between markers and anal cancer risk.

Main Results:

• Patients with anal cancer exhibited higher NLR and PLR, and lower PNI and CD4/CD8 ratio compared to those without anal cancer.
• Multivariate analysis revealed that only PNI (OR 0.90, p=0.001) and CD4/CD8 ratio (OR 0.05, p<0.001) were significantly associated with increased anal cancer risk.
• The CD4/CD8 ratio demonstrated the strongest predictive value for anal cancer risk.

Conclusions:

• While NLR and PLR show independent correlation, PNI and CD4/CD8 ratio are the statistically significant biomarkers for anal cancer in PLWH when controlling for other factors.
• The CD4/CD8 ratio is identified as the most potent immune inflammatory marker for predicting anal cancer risk among HIV-infected veterans.
• These findings highlight the importance of monitoring PNI and CD4/CD8 ratio in PLWH for anal cancer risk assessment.