{"title":"HIV/AIDS患者中性粒细胞减少的相关因素和预后意义。","authors":"Pengpeng Li, Xiaoyan Lv, Hui Shen, Jiamin Fang, Mingrui Wei, Xiaoyan Liu, Fuling Zhou","doi":"10.1186/s12985-025-02624-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 × 10<sup>9</sup>/L, 33.7%) and non-neutropenia group (ANC ≥ 2.0 × 10<sup>9</sup>/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.</p><p><strong>Results: </strong>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<sup>+</sup>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 × 10<sup>9</sup>/L) had a worse prognosis than Grade 1 neutropenia group (0.5 × 10<sup>9</sup>/L ≤ ANC<2 × 10<sup>9</sup>/L, p = 0.019) and non-neutropenia group (ANC ≥ 2.0 × 10<sup>9</sup>/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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23616,"journal":{"name":"Virology Journal","volume":"22 1","pages":"6"},"PeriodicalIF":4.0000,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721557/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associated factors and prognostic implications of neutropenia in individuals with HIV/AIDS.\",\"authors\":\"Pengpeng Li, Xiaoyan Lv, Hui Shen, Jiamin Fang, Mingrui Wei, Xiaoyan Liu, Fuling Zhou\",\"doi\":\"10.1186/s12985-025-02624-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 × 10<sup>9</sup>/L, 33.7%) and non-neutropenia group (ANC ≥ 2.0 × 10<sup>9</sup>/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.</p><p><strong>Results: </strong>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<sup>+</sup>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 × 10<sup>9</sup>/L) had a worse prognosis than Grade 1 neutropenia group (0.5 × 10<sup>9</sup>/L ≤ ANC<2 × 10<sup>9</sup>/L, p = 0.019) and non-neutropenia group (ANC ≥ 2.0 × 10<sup>9</sup>/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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23616,\"journal\":{\"name\":\"Virology Journal\",\"volume\":\"22 1\",\"pages\":\"6\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2025-01-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721557/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Virology Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12985-025-02624-x\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"VIROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Virology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12985-025-02624-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VIROLOGY","Score":null,"Total":0}
Associated factors and prognostic implications of neutropenia in individuals with HIV/AIDS.
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.
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.
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