Monocyte-to-lymphocyte ratio as a predictor of TB among people living with HIV
Monocyte-to-lymphocyte ratio as a predictor of TB among people living with HIV
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DOI：
10.5588/ijtld.21.0300
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发表时间：
2021-11-01
影响因子：
4
通讯作者：
Cobelens, F.
中科院分区：
文献类型：
--
作者：
Gatechompol, S.;Sophonphan, J.;Cobelens, F.
背景：诊断工具，以确定早期或亚临床结核病阶段将有助于预防干预。外周血中单核细胞与淋巴细胞的比值（ML比值）可能是预测TB的一个简单生物标志物。方法：我们评估了抗逆转录病毒治疗（ART）开始后，艾滋病病毒感染者（PLWH）中多个时间更新的ML比率测量值与结核病发病率之间的关系。ML比率至少每6个月更新一次。使用四分位数的ML比率计算根据时间更新的ML比率分层的TB发病率及其相应的95%置信区间。结果：共有1305例PLWH纳入分析：46例发生TB，1259例保持无TB。在ML比率>0.25的参与者中，TB发病率为10.3（95%CI 7.1-14.9）例/1000患者年（PYR），而在ML比率为0.15的参与者中，TB发病率为1.1/1000 PYR（95%CI 0.4-2.9）。在临界点0.23时，ML比率提供的受试者工作特征曲线下诊断面积（AROC）为0.849（95%CI 0.784-0.914），灵敏度为85%，特异性为71%。结论：ML比率增加可预测ART治疗期间或治疗后PLWH中发生的结核病。ML比率可作为PLWH中结核病风险分层的简单工具。
BACKGROUND: Diagnostic tools to identify incipient or subclinical TB stages will be helpful for preventive intervention. A simple biomarker to predict TB may be the monocytes to lymphocytes ratio (ML ratio) in peripheral blood. METHODS: We assessed the relationship between multiple time-updated ML ratio measurements and incidence of TB in people living with HIV (PLWH) after antiretroviral therapy (ART) was initiated. The ML ratio was updated at least every 6 months. TB incidence with corresponding 95% confidence intervals stratified according to time-updated ML ratio was calculated using ML ratio in quartiles. RESULTS: A total of 1305 PLWH were included in the analyses: 46 had incident TB and 1259 remained TB free. The TB incidence rate was 10.3 (95% CI 7.1-14.9) cases/1000 patient-years (PYR) among participants with ML ratio >0.25 compared with 1.1/1000 PYR (95% CI 0.4-2.9) among those with ML ratio ,0.15. At cut point 0.23, the ML ratio provided a diagnostic area under the receiver operating characteristics curve (AROC) of 0.849 (95% CI 0.784-0.914 ) and a sensitivity of 85% and specificity of 71%. CONCLUSION: Increased ML ratio was predictive of incident TB among PLWH on or after ART. The ML ratio can be a simple tool to stratify the risk of TB in PLWH.