Evaluation value of SIRI combined with baseline indicators in immune reconstitution of PLWH after ART: A cohort study

Successful immune reconstitution in people living with human immunodeficiency virus (PLWH) directly affects their prognosis. Although numerous studies have identified baseline indicators as risk factors, they do not fully capture systemic immune dysfunction in immunological nonresponders. We evaluated the usefulness of the systemic inflammatory response index (SIRI) combined with age, baseline CD4+ cell count, and baseline viral load in PLWH undergoing antiretroviral therapy (ART) with the aim of providing a reference for early intervention in poor immune reconstitution. We retrospectively analyzed PLWH who had been receiving ART for more than 4 years. Those with viral loads below 50 copies/mL for over 3 years with a CD4+ cell count <350 cells/μL were categorized into the poor immune reconstitution group, whereas those with counts ≥350 cells/μL were classified into the good group. A receiver operating characteristic curve was drawn to analyze the assessment of SIRI combined with the baseline indicators of poor immune reconstitution. The median baseline viral load in the poor group was 5.08, which was higher than that in the good group at 4.18 (P < .001). SIRI was positively correlated with the CD4+ cell count (r = 0.275, P = .004). Logistic regression analysis indicated that age, baseline CD4+ cell count, baseline viral load, and SIRI were the risk factors for poor immune reconstitution. Receiver operating characteristic curve analysis suggested that the area under the curve for SIRI combined with baseline indicators in assessing poor immune reconstitution was 0.835, 95% confidence interval 0.759-0.910, P < .001, which was higher than that for each of the 4 indicators monitored separately (0.615, 0.616, 0.708, and 0.734). SIRI combined with baseline indicators has a good assessment value for poor immune reconstitution in PLWH after ART.