单细胞与淋巴细胞的比率和血红蛋白水平在开始抗逆转录病毒治疗后预测结核病
Sivaporn Gatechompol1,2,3, Stephen J Kerr1,4, Sandra W Cardoso5
1HIV-NAT, Thai Red Cross AIDS Research Center.
AIDS (London, England)
|September 11, 2023
概括
单细胞与淋巴细胞比率 (MLR) 和贫血严重程度可以预测艾滋病毒感染者开始抗逆转录病毒治疗 (ART) 的结核病 (TB) 发病率. 这些生物标志物有助于识别高风险个体,以便及时进行干预.
科学领域:
- 传染病流行病学 传染病流行病学
- 临床生物标志物研究研究
- 艾滋病毒/艾滋病 医学 医学
背景情况:
- 结核病 (TB) 仍然是艾滋病毒感染者 (PWH) 的重大威胁.
- 在开始抗逆转录病毒疗法 (ART) 后,对结核病发病率的早期预测对于有效管理至关重要.
- 在PWH中确定可靠的结核病风险分层生物标志物是一个持续的挑战.
研究的目的:
- 评估单细胞与淋巴细胞比率 (MLR) 和贫血严重程度的预测性表现.
- 评估MLR和贫血在预测开始ART的PWH中结核病发病率方面的联合实用性.
- 在PWH.中为结核病预防和诊断提供临床决策的信息.
主要方法:
- 一个多中心,回顾性队列研究,利用PEARLS研究 (A5175) 的数据.
- 考克斯回归分析被用来确定MLR,贫血和发生结核病之间的关联.
- 哈雷尔的C指数被用来评估模型的歧视力.
主要成果:
- 基线MLR≥0.23与结核病风险增加1.77倍相关 (P=0.04).
- 轻度/中度和重度贫血的结核病危险比率显著更高 (分别为3.35和18.16).
- 结合MLR和贫血改善了预测准确度,MLR的调整危险比≥0.23,轻度/中度和重度贫血分别为1.83,3.38和19.09.
结论:
- 基线MLR和血红蛋白水平是启动ART的PWH中结核病风险的有价值预测指标.
- 这些易于获得的生物标志物可以帮助在ART开始时识别高风险个体.
- 利用MLR和贫血状态可以指导诊断和管理策略,以减轻PWH的结核病发病率.
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