Incidence and significance of elevated platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios among hospitalised HIV-positive adult patients

Abstract

There is increasing interest in the peripheral blood platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) as markers of systemic inflammation. We audited records of unselected hospitalised HIV-positive adults to identify the frequency of elevated PLR and NLR, potential associations with specific diagnoses, and outcome. Of 259 patients audited, their median age was 47 years (interquartile range = 41–54); 188 (73%) were men. An elevated PLR occurred in 87 patients (33.6%); 67 (25.9%) had an elevated NLR; 200 (77%) had an elevated C-reactive protein (CRP). Elevated PLR and NLR was associated with a variety of infectious, inflammatory, and malignant conditions similar to conditions described in the general non-HIV-infected adult population. Additionally, elevated PLR and NLR occurred both in patients in receipt of antiretroviral therapy (with undetectable viral loads), as well as in those with newly-diagnosed and poorly-controlled infection. Fourteen patients with infectious and inflammatory conditions had an elevated PLR and normal CRP, with/without elevated NLR. There was no association between elevated PLR or NLR and ICU admission, p = 0.1001 and p = 0.605, respectively. Elevated NLR, but not PLR was associated with death, p = 0.0405 and p = 1.000, respectively: two-tailed Fisher’s exact test. The single site nature of the audit and relatively small number of patients limits these observations.

High Pretreatment Level of Neutrophil to Lymphocyte Ratio, Monocyte to Lymphocyte Ratio and Other Factors Associated with Delayed Sputum Conversion in Patients with Pulmonary Tuberculosis

“… 16 HIV infection by itself has been shown as a strong predictor of active TB disease and a poor TB treatment outcome. 17 , 18 On the contrary, in our study HIV was not associated with a delayed intensive phase sputum conversion, which is possibly due to a smaller number of HIV patients involved in our study, therefore it was inadequate to detect the different outcomes of TB treatment between HIV patients and non-HIV patients.…”

Neutrophil-to-lymphocyte ratio and lactate dehydrogenase for early diagnosis of AIDS patients with Talaromyces marneffei infection

“…Merriman et al (28), in a study of 259 unselected adult HIV-infected patients, found that NLR was elevated in both primary well-controlled and poorly-controlled HIVinfected patients. Most were accompanied by elevated C-reactive protein (CRP), with a minority of patients having normal CRP at the time of NLR elevation, and this was mainly seen in patients with other coinfections.…”

“…NLR has a high value in the diagnosis and prognosis of inflammatory diseases, tumors, and coronary heart disease. Merriman et al used the NLR as a diagnostics method for HIV-positive adult patients (9). Compared with Merriman's study, we used NLR for diagnosing the AIDS patients with TM infection.…”

Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratio as Predictors of CD4 Count among People Living with HIV

“…9 Another cohort study also found that HIV patients with Non-AIDS-Defining Cancers (NADCs) who had increased NLR and PLR had a higher risk of death. 50 A research conducted by Merriman et al 51 involving 259 HIV patients, proved that increased NLR and PLR could arise among patients who were receiving ARV treatment or patients who were newly diagnosed with uncontrolled infections. 51 This study revealed that increased NLR was associated with patient mortality (p = 0.0405).…”