{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:30:35Z","timestamp":1789475435015,"version":"build-2803163510"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The Systemic Immune-Inflammation Index (SII) shows promise as a biomarker to assess immune status and inflammation, but its utility in predicting surgical site infections (SSIs) among HIV-infected patients remains underexplored. To evaluate SII\u2019s predictive value for SSI risk in HIV-positive surgical patients in China, suggesting an effective clinical tool for this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study included HIV-infected patients with fractures from three hospitals. Baseline data on demographics, HIV metrics, comorbidities, and surgical details were collected. Univariate and multivariate logistic regression analyses examined the relationship between preoperative SII and postoperative SSIs, adjusting for potential confounders like age, gender, CD4 count, viral load, and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 338 HIV patients, 36 (10.65%) developed postoperative SSIs. SSI patients had significantly higher SII levels. Bivariate logistic regression analysis showed that HIV viral load, open fracture, albumin, CD4, CD4\/CD8 ratio and SII were risk factors for surgical site infection in HIV-positive patients. Multivariate analysis confirmed SII as an independent predictor of SSI (OR = 3.28, 95% CI = 2.07\u20135.54). SII showed good discriminatory performance (AUC = 0.810) and performed better than the CD4\/CD8 ratio (AUC = 0.689), which was included as a representative immune-status marker. Subgroup analyses validated SII\u2019s stability across patient subsets. Further, smooth curve fitting and RCS analysis showed that there was still a linear correlation between SII and surgical site infection in different subgroups of CD4 and HIV viral load (P for nonlinear &amp;gt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SII may serve as a clinically accessible and cost-effective biomarker for identifying HIV-infected patients at increased risk of SSI. Incorporating preoperative SII assessment could support perioperative risk stratification and management. This novel approach has implications for optimizing patient care for HIV-positive surgical populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1529202","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T06:37:11Z","timestamp":1770359831000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Systemic immune-inflammation index as a novel biomarker for predicting surgical site infection in people living with HIV: a multicenter, retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Shuo","family":"Gong","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Soft Tissue Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Cheeloo College of Medicine, Shandong University","place":["Qingdao, China"]},{"name":"Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, National Center for Infectious Diseases","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, National Center for Infectious Diseases","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chengdu Public Health Clinical Medical Center","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Changsha First Hospital, Xiangya Medical College","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Beijing Ditan Hospital, Capital Medical University, National Center for Infectious Diseases","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changsheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Soft Tissue Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanguo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Qilu Hospital of Shandong University (Qingdao), Cheeloo College of Medicine, Shandong University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"B5","doi-asserted-by":"publisher","first-page":"e288","DOI":"10.1016\/S1473-3099(16)30402-9","article-title":"New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective","volume":"16","author":"Allegranzi","year":"2016","journal-title":"Lancet Infect. 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