Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events

Background While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear.Methods We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year t...

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Authors: Martínez-Sanz, J, Diaz-alvarez, J, Rosas, M, Ron, R, Iribarren, JA, Bernal, E, Gutiérrez, F, Sancho, AR, Cabello, N, Olalla, J, Moreno, S, Serrano-Villar, S
Format: article
Status:Published version
Publication Date:2023
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16197
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/16197
Access Level:Open access
Keyword:HIV
Non-AIDS events
Neoplasia
Cardiovascular event
CD4/CD8 ratio
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spelling Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS eventsMartínez-Sanz, JDiaz-alvarez, JRosas, MRon, RIribarren, JABernal, EGutiérrez, FSancho, ARCabello, NOlalla, JMoreno, SSerrano-Villar, SHIVNon-AIDS eventsNeoplasiaCardiovascular eventCD4/CD8 ratioBackground While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear.Methods We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events.Findings The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio <0.3 predicted an increased risk of SNAEs during the next five years (OR 1.63, 95% CI 1.03-2.58). The effect was stronger at a CD4/CD8 ratio cut-off of <0.2 (OR 3.09, 95% CI 1.57-6.07). Additionally, low CD4 count at cut-offs of <500 cells/mu L predicted an increased risk of clinical events. Among participants with a CD4 count >500 cells/mu L, a CD8 count >1500 cells/mu L or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.Interpretation Our results support the use of the CD4/CD8 ratio and CD8 count as predictors of clinical progression. Patients with CD4/CD8 ratio <0.3 or CD8 count >1500/mu L, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.Copyright (c) 2023 The Author(s). Published by Elsevier B.V.ELSEVIER2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16197EBioMedicineISSN: 23523964reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p161972026-06-11T12:45:17Z
dc.title.none.fl_str_mv Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
title Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
spellingShingle Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
Martínez-Sanz, J
HIV
Non-AIDS events
Neoplasia
Cardiovascular event
CD4/CD8 ratio
title_short Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
title_full Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
title_fullStr Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
title_full_unstemmed Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
title_sort Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
dc.creator.none.fl_str_mv Martínez-Sanz, J
Diaz-alvarez, J
Rosas, M
Ron, R
Iribarren, JA
Bernal, E
Gutiérrez, F
Sancho, AR
Cabello, N
Olalla, J
Moreno, S
Serrano-Villar, S
author Martínez-Sanz, J
author_facet Martínez-Sanz, J
Diaz-alvarez, J
Rosas, M
Ron, R
Iribarren, JA
Bernal, E
Gutiérrez, F
Sancho, AR
Cabello, N
Olalla, J
Moreno, S
Serrano-Villar, S
author_role author
author2 Diaz-alvarez, J
Rosas, M
Ron, R
Iribarren, JA
Bernal, E
Gutiérrez, F
Sancho, AR
Cabello, N
Olalla, J
Moreno, S
Serrano-Villar, S
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv HIV
Non-AIDS events
Neoplasia
Cardiovascular event
CD4/CD8 ratio
topic HIV
Non-AIDS events
Neoplasia
Cardiovascular event
CD4/CD8 ratio
description Background While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear.Methods We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events.Findings The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio <0.3 predicted an increased risk of SNAEs during the next five years (OR 1.63, 95% CI 1.03-2.58). The effect was stronger at a CD4/CD8 ratio cut-off of <0.2 (OR 3.09, 95% CI 1.57-6.07). Additionally, low CD4 count at cut-offs of <500 cells/mu L predicted an increased risk of clinical events. Among participants with a CD4 count >500 cells/mu L, a CD8 count >1500 cells/mu L or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.Interpretation Our results support the use of the CD4/CD8 ratio and CD8 count as predictors of clinical progression. Patients with CD4/CD8 ratio <0.3 or CD8 count >1500/mu L, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.Copyright (c) 2023 The Author(s). Published by Elsevier B.V.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16197
url https://fisabio.portalinvestigacion.com/publicaciones/16197
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv EBioMedicine
ISSN: 23523964
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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