Associated factors and prognostic implications of neutropenia in individuals with HIV/AIDS.

IF 4 3区医学 Q2 VIROLOGY

Virology Journal Pub Date : 2025-01-09 DOI:10.1186/s12985-025-02624-x

Pengpeng Li, Xiaoyan Lv, Hui Shen, Jiamin Fang, Mingrui Wei, Xiaoyan Liu, Fuling Zhou

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Abstract

Background: Neutropenia frequently presents as a hematological manifestation among people living with HIV/AIDS (PLWHA). This study explores the factors associated with neutropenia in PLWHA and its prognostic significance.

Methods: We conducted a retrospective case-control study of the clinical data from 780 cases of individuals living with HIV/AIDS, who were admitted to Zhongnan Hospital of Wuhan University over the period from January 2016 to September 2020. We categorized the patients into two different groups based on absolute neutrophil Count (ANC): neutropenia group (ANC < 2.0 × 10⁹/L, 33.7%) and non-neutropenia group (ANC ≥ 2.0 × 10⁹/L, 66.3%). We analyzed the co-infections, blood routine test, infection indicators, lymphocyte subpopulation, bone marrow cell cytology, bone marrow morphology in both groups. Additionally, we analyzed the prognosis of the patients.

Results: The results of multifactorial logistic regression showed that increased C-reactive protein (CRP) (p<0.001, adjusted odds ratio [AOR] = 0.984, 95% CI:0.975-0.993), Monocyte (MONO) (p = 0.011, AOR = 0.091, 95% CI: 0.013-0.637), CD19⁺B lymphocytes (p = 0.008, AOR = 0.990, 95% CI: 0.983-0.997), Bone marrow granulocyte (p = 0.017, AOR = 0.936, 95% CI: 0.883-0.992) were protective factors for neutropenia in PLWHA. Kaplan-Meier survival curve analysis showed that Grade 2 neutropenia group (ANC<0.5 × 10⁹/L) had a worse prognosis than Grade 1 neutropenia group (0.5 × 10⁹/L ≤ ANC<2 × 10⁹/L, p = 0.019) and non-neutropenia group (ANC ≥ 2.0 × 10⁹/L, p = 0.008). Older age (p = 0.002), lower hemoglobin levels (p = 0.001), and a reduced proportion of bone marrow granulocytes (p = 0.002) were associated with a poorer prognosis in PLWHA.

Conclusion: HIV infection can lead to reduced neutrophil counts and damage to the immune system through multiple pathways. Severe neutropenia results in a worse prognosis, making timely diagnosis and treatment of neutropenia in this population essential.

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HIV/AIDS患者中性粒细胞减少的相关因素和预后意义。

背景：中性粒细胞减少症在HIV/AIDS （PLWHA）患者中经常表现为血液学表现。本研究探讨PLWHA患者中性粒细胞减少的相关因素及其预后意义。方法：对2016年1月至2020年9月武汉大学中南医院收治的780例HIV/AIDS感染者的临床资料进行回顾性病例对照研究。根据绝对中性粒细胞计数（ANC）将患者分为两组：中性粒细胞减少组（ANC 9/L, 33.7%）和非中性粒细胞减少组（ANC≥2.0 × 109/L, 66.3%）。分析两组患者合并感染情况、血常规、感染指标、淋巴细胞亚群、骨髓细胞细胞学、骨髓形态。此外，我们还分析了患者的预后。结果：多因素logistic回归结果显示，c反应蛋白（CRP）升高(p+B淋巴细胞（p = 0.008, AOR = 0.990, 95% CI: 0.983 ~ 0.997）、骨髓粒细胞（p = 0.017, AOR = 0.936, 95% CI: 0.883 ~ 0.992）是PLWHA患者中性粒细胞减少的保护因素。Kaplan-Meier生存曲线分析显示，2级中性粒细胞减少组（ANC9/L）预后差于1级中性粒细胞减少组（0.5 × 109/L≤ANC9/L, p = 0.019）和非中性粒细胞减少组（ANC≥2.0 × 109/L, p = 0.008）。年龄较大（p = 0.002）、血红蛋白水平较低（p = 0.001）和骨髓粒细胞比例降低（p = 0.002）与PLWHA患者预后较差相关。结论：HIV感染可通过多种途径导致中性粒细胞计数减少和免疫系统损伤。严重的中性粒细胞减少会导致较差的预后，因此在这一人群中及时诊断和治疗中性粒细胞减少至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Virology Journal 医学-病毒学

CiteScore

7.40

自引率

2.10%

发文量

186

审稿时长

1 months

期刊介绍： Virology Journal is an open access, peer reviewed journal that considers articles on all aspects of virology, including research on the viruses of animals, plants and microbes. The journal welcomes basic research as well as pre-clinical and clinical studies of novel diagnostic tools, vaccines and anti-viral therapies. The Editorial policy of Virology Journal is to publish all research which is assessed by peer reviewers to be a coherent and sound addition to the scientific literature, and puts less emphasis on interest levels or perceived impact.