Relationship between cd4 count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and left ventricular systolic function in HIV/AIDS patients

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)

Results: 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.