Old Age, B Cell Function and Count Are the Critical Factors for Predicting Infection Risk in Patients With Autoimmune...

Area of Science:

• Rheumatology
• Immunology
• Infectious Disease Epidemiology

Background:

• Autoimmune rheumatic diseases (ARDs) increase infection risk, especially with immunosuppressive therapy.
• Identifying patients at high risk for infection is crucial for optimizing treatment and preventing complications.

Purpose of the Study:

• To assess baseline immune parameters predicting infection risk in ARD patients.
• To identify individuals requiring intensified immunosuppressive therapy based on infection rates.

Main Methods:

• A prospective cohort study of 102 adult ARD patients undergoing immunosuppression in India.
• Baseline immune assessments included complete hemogram, inflammatory markers, immunoglobulins, immune cell counts, complement levels, and viral markers.
• One-year follow-up for infection episodes, with Ordinary Least Squares (OLS) regression analysis to identify predictors of infection risk.

Main Results:

• Younger age, lower immunoglobulin E (IgE), methotrexate (MTX), and biologic use were protective.
• Risk factors for infection included older age, lower Immunoglobulin G (IgG), elevated neutrophil counts, higher neutrophil-to-lymphocyte ratios (NLR), low platelet counts, and steroid use.
• OLS regression identified age, IgG, CD19 lymphocyte counts, white blood cell (WBC) counts, and erythrocyte sedimentation rate (ESR) as significant predictors.

Conclusions:

• Older age, low IgG, and low CD19 B cell counts predict infection susceptibility in ARD patients.
• High neutrophil counts, low platelets, and elevated NLR are key predictors of infection development.
• Tailored monitoring and treatment strategies are essential to mitigate infection risks in this population.