title: The predictive role of NLR and PLR for solid non-AIDS defining cancer incidence in HIV-infected subjects: a MASTER cohort study.
abstract: BACKGROUND
  The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two low cost, routinely available inflammatory indices, have been found to be associated with risk of death in patients with solid cancer, in both general population and HIV-positive subjects. However, no study investigated the role of NLR and PLR as predictive of cancer incidence so far.
  
  
  METHODS
  The aim of our study was to assess the association of PLR and NLR with risk of developing solid non-AIDS defining cancer (NADC) in HIV-infected subjects. We conducted a multicenter Italian cohort study from 2000 to 2012 including HIV-infected subjects naïve at antiretroviral treatment at enrollment. The associations of NLR and PLR with NADC incidence were evaluated by univariate and multivariate analyses using both time independent and time dependent Cox proportional hazard models.
  
  
  RESULTS
  Thirteen thousand five hundred fifty-nine patients (73.3 % males) with a mean age of 36.0 years (SD 10.0) were included. The median (inter-quartile range) of NLR and PLR at baseline were 1.47 (1.03-2.17) and 109.9 (79.6-155.3), respectively. During a median follow-up of 3.9 years, 337 subjects had a first diagnosis of solid NADC. The crude and age- and gender-standardized incidence rates were 3.57 and 3.91 per 1000 person-years, respectively. No statistically significant association was found between NLR and PLR and NADC incidence, using multivariate models, including also time-dependent Cox models with a cubic-spline for NLR and PLR.
  
  
  CONCLUSIONS
  This study does not sustain the hypothesis that NRL and PLR may be useful for predicting the risk of cancer in HIV positive subjects.
authors.affiliation: Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Raffetti
authors.affiliation: Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Donato
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Castelli
authors.affiliation: Clinical Infectious Diseases, Ospedale Papa Giovanni XXIII of Bergamo, Bergamo, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Maggiolo
authors.affiliation: Fondazione Malattie Infettive e Salute Internazionale, Brescia, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Carosi
authors.affiliation: University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Quiros-Roldan
keywords: Cancer; HIV; Inflammation-based biomarkers; NLR; PLR