The CD4:CD8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery. Issue 1 (6th September 2013)

• Record Type: Journal Article
• Authors: Serrano‐Villar, S; Moreno, S; Fuentes‐Ferrer, M; Sánchez‐Marcos, C; Ávila, M; Sainz, T; de, NGP; Fernández‐Cruz, A; Estrada, V
• Is Part Of: HIV medicine. Volume 15:Issue 1(2014:Jan.)
• Page Start: 40
• Page End: 49
• Publication Date: 2013-09-06
• Subjects: HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12081
• Languages: English
• ISSNs: 1464-2662

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hiv12081-sec-0001" sec-type="section"> <title>Objectives</title> <p>Inversion of the CD4:CD8 ratio (< 1) has been identified as a hallmark of inmmunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and markers of age‐associated disease in treated HIV‐infected patients with good immunovirological response.</p> </sec> <sec id="hiv12081-sec-0002" sec-type="section"> <title>Methods</title> <p>A cross‐sectional analysis was conducted in 132 HIV‐infected adults on antiretroviral therapy (ART), with plasma HIV RNA < 50 HIV‐1 RNA copies/mL for at least 1 year, CD4 count > 350 cells/μL and age < 65 years. We analysed the associations between the CD4:CD8 ratio and subclinical atherosclerosis [assessed using carotid intima‐media thickness (IMT)], arterial stiffness [assessed using the augmentation index (AIx)], the estimated glomerular filtration rate (eGFR), muscle wasting and sarcopenia [assessed using appendicular lean mass/height<sup>2</sup> (ALM) measured by dual‐energy X‐ray absorptiometry (DEXA)].</p> </sec> <sec id="hiv12081-sec-0003" sec-type="section"> <title>Results</title> <p>CD4:CD8 ratio inversion was associated with higher IMT, lower eGFR and lower ALM (all values <italic>P</italic> < 0.05), but not with AIx. In multivariate analyses adjusted for age, sex, hypertriglyceridaemia, tobacco use and cumulative ART exposure, inversion of the CD4:CD8 ratio was independently associated with higher IMT [odds ratio (OR) 2.9; 95% confidence interval (CI) 1.2–7.1], arterial stiffness (OR 4.8; 95% CI 1.0–23.5) and lower eGFR (OR 5.2; 95% CI 1.0–64.4), but not sarcopenia (OR 0.7; 95% CI 0.2–2.7). These associations persisted when models were applied to subjects with nadir CD4 counts > 200 cells/μL and those with CD4 counts > 500 cells/μL.</p> </sec> <sec id="hiv12081-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The CD4:CD8 ratio in treated HIV‐infected subjects with good immunovirological response is independently associated with markers of age‐associated disease. Hence, it might be a clinically useful predictor of non‐AIDS‐defining conditions.</p> </sec> </abstract>