The CD4:CD8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery

• Published in: HIV medicine Vol. 15; no. 1; pp. 40 - 49
• Main Authors: Serrano‐Villar, S, Moreno, S, Fuentes‐Ferrer, M, Sánchez‐Marcos, C, Ávila, M, Sainz, T, Villar, NGP, Fernández‐Cruz, A, Estrada, V
• Format: Journal Article
• Language: English
• Published: England 01.01.2014
• Subjects: Adult; Age Factors; Aging - immunology; Atherosclerosis - immunology; Atherosclerosis - pathology; Biomarkers; carotid intima‐media thickness; CD4-CD8 Ratio; Cross-Sectional Studies; Female; Glomerular Filtration Rate; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - virology; HIV Wasting Syndrome - pathology; Human immunodeficiency virus 1; Humans; Kidney Diseases - etiology; Kidney Diseases - metabolism; Male; Middle Aged; Multivariate Analysis; Muscle Weakness - immunology; premature aging; sarcopenia; Sarcopenia - pathology; Vascular Diseases - etiology; Vascular Diseases - pathology; vascular stiffness; Vascular Stiffness - immunology; vascular stiffness; HIV; CD4:CD8 ratio; carotid intima-media thickness; premature aging; sarcopenia
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/hiv.12081

Objectives 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. 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, 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/height2 (ALM) measured by dual‐energy X‐ray absorptiometry (DEXA)]. Results CD4:CD8 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 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. Conclusions 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.