Relationship Between CD4 Count, Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio and Left Ventricular Systolic Function in HIV/AIDS Patients
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Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Kenyan Medical Association.
Abstract
Background: Inflammation is a cardinal feature of Human Immunodeficiency
Virus (HIV) infection and accounts for most of its clinical manifestations.
Cardiovascular involvement is common in HIV. Haematologic inflammatory
markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte
ratio (PLR) are elevated in some cardiovascular diseases in the non-HIV
population. CD4 count correlates with left ventricular size. The relationship
between haematologic inflammatory markers NLR and PLR and left ventricular
(LV) systolic function and their prognostic value is not well studied in HIV
patients.
Objective: To determine the relationship between CD4 count, NLR and PLR and
LV ejection fraction (EF) and their diagnostic value as surrogates for the occurrence
of LV systolic dysfunction (LVSD)
Design: Cross-sectional
Setting: The Cardiology unit of the University of Ilorin Teaching Hospital (UITH),
Ilorin, Nigeria
Participants: 150 HIV positive patients
Outcome measures: The relationship between CD4 count, NLR and PLR and LV
ejection fraction (EF) and their diagnostic value for the occurrence of LV systolic
dysfunction (LVSD)
esults: The mean age was 37.14+8.6 years, 86 (64%) female, median duration of
illness 6(0.94-24) months. NLR and PLR had a negative correlation with LV EF, the
CD4 count had positive correlation. On multivariate analysis only PLR was
predictive of EF. A cut-off PLR of 169.5 was only weakly discriminatory of LVSD
with sensitivity of 81.3% and specificity of 72.9%, AUC 0.794.
Conclusion: CD4 count, and inflammatory markers correlate with LVEF in HIV
patients. Only PLR was predictive, its value as a diagnostic surrogate for LVSD
needs further investigation.
Description
Keywords
HIV, CD4COUNT, LEFT VENTRICULAR SYSTOLIC FUNCTION
Citation
East African Medical Journal 100(1):5520-5529