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The CD 4: CD 8 ratio is associated with markers of age‐associated disease in virally suppressed HIV ‐infected patients with immunological recovery
Author(s) -
SerranoVillar S,
Moreno S,
FuentesFerrer M,
SánchezMarcos C,
Ávila M,
Sainz T,
Villar NGP,
FernándezCruz A,
Estrada V
Publication year - 2014
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12081
Subject(s) - medicine , odds ratio , confidence interval , sarcopenia , subclinical infection , gastroenterology , arterial stiffness , population , immunology , endocrinology , environmental health , blood pressure
Objectives Inversion of the CD 4: CD 8 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 CD 4: CD 8 ratio and markers of age‐associated disease in treated HIV ‐infected patients with good immunovirological response. Methods 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, CD 4 count > 350 cells/μL and age < 65 years. We analysed the associations between the CD 4: CD 8 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 2 ( ALM ) measured by dual‐energy X ‐ray absorptiometry ( DEXA )]. Results CD 4: CD 8 ratio inversion was associated with higher IMT , lower eGFR and lower ALM (all values P < 0.05), but not with AIx . In multivariate analyses adjusted for age, sex, hypertriglyceridaemia, tobacco use and cumulative ART exposure, inversion of the CD 4: CD 8 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 CD 4 counts > 200 cells/μL and those with CD 4 counts > 500 cells/μL. Conclusions The CD 4: CD 8 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.