Aging, trends in CD4+/CD8+ cell ratio, and clinical outcomes with persistent HIV suppression in a dynamic cohort of ambulatory HIV patients
| العنوان: | Aging, trends in CD4+/CD8+ cell ratio, and clinical outcomes with persistent HIV suppression in a dynamic cohort of ambulatory HIV patients |
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| المؤلفون: | Richard M. Novak, Carl Armon, Linda Battalora, Kate Buchacz, Jun Li, Douglas Ward, Kimberly Carlson, Frank J. Palella |
| المصدر: | AIDS. 36:815-827 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2022. |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | CD4-Positive T-Lymphocytes, Aging, Anti-HIV Agents, Immunology, CD4-CD8 Ratio, Infant, HIV Infections, CD8-Positive T-Lymphocytes, Viral Load, CD4 Lymphocyte Count, Infectious Diseases, Antiretroviral Therapy, Highly Active, Humans, Immunology and Allergy |
| الوصف: | Age blunts CD4+ lymphocyte cell count/μl (CD4+) improvements observed with antiretroviral therapy (ART)-induced viral suppression among people with HIV (PWH). Prolonged viral suppression reduces immune dysregulation, reflected by rising CD4+/CD8+ ratios (CD4+/CD8+). We studied CD4+/CD8+ over time to determine whether it predicts risk for select comorbidities and mortality among aging PWH with viral suppression.We studied HIV Outpatient Study (HOPS) participants prescribed ART during 2000-2018 who achieved a viral load less than 200 copies/ml on or after 1 January 2000, and remained virally suppressed at least 1 year thereafter. We modeled associations of CD4+/CD8+ with select incident comorbidities and all-cause mortality using Cox regression and controlling for demographic and clinical factors.Of 2480 eligible participants,1145 (46%) were aged less than 40 years, 835 (34%) 40-49 years, and 500 (20%) ≥ 50 years. At baseline, median CD4+/CD8+ was 0.53 (interquartile range: 0.30-0.84) and similar among all age groups (P = 0.18). CD4+/CD8+ values and percentage of participants with CD4+/CD8+ at least 0.70 increased within each age group (P 0.001 for all). CD4+/CD8+ increase was greatest for PWH aged less than 40 years at baseline. In adjusted models, most recent CD4+/CD8+less than 1.00 and less than 0.70 were independently associated with higher risk of non-AIDS cancer and mortality, respectively.Pretreatment immune dysregulation may persist as indicated by CD4+/CD8+ less than 0.70. Persistent viral suppression can improve immune dysregulation over time, reducing comorbidity, and mortality risk. Monitoring CD4+/CD8+ among ART-treated PWH with lower values provide a means to assess for mortality and comorbidity risk. |
| تدمد: | 1473-5571 0269-9370 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::92e17226d205ec62bf4b9f4648165068Test https://doi.org/10.1097/qad.0000000000003171Test |
| رقم الانضمام: | edsair.doi.dedup.....92e17226d205ec62bf4b9f4648165068 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14735571 02699370 |
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