CD4:CD8 Ratio and CD8 Cell Count and Their Prognostic Relevance for Coronary Heart Disease Events and Stroke in Antiretroviral Treated Individuals: The Swiss HIV Cohort Study.
Humans
CD4-CD8 Ratio
HIV Infections
/ complications
Cohort Studies
Prognosis
Cardiovascular Diseases
/ drug therapy
Switzerland
CD4-Positive T-Lymphocytes
CD8-Positive T-Lymphocytes
Anti-Retroviral Agents
/ adverse effects
Viral Load
Biomarkers
Coronary Disease
/ epidemiology
Stroke
/ epidemiology
CD4 Lymphocyte Count
Anti-HIV Agents
/ adverse effects
Journal
Journal of acquired immune deficiency syndromes (1999)
ISSN: 1944-7884
Titre abrégé: J Acquir Immune Defic Syndr
Pays: United States
ID NLM: 100892005
Informations de publication
Date de publication:
15 12 2022
15 12 2022
Historique:
received:
24
02
2022
accepted:
05
07
2022
pubmed:
24
9
2022
medline:
15
11
2022
entrez:
23
9
2022
Statut:
ppublish
Résumé
HIV infection leads to a persistent expansion of terminally CD8 T cells and CD8 T suppressor cells, a marker of chronic immune activation leading to a low CD4:CD8 ratio that may persist in the presence of potent antiretroviral therapy and regained CD4 helper cells. It remains unclear whether a low CD4:CD8 ratio is associated with cardiovascular diseases. We conducted an observational cohort study to investigate the association of immune depression and activation as characterized by the proxy of the CD4:CD8 ratio on the hazard of coronary heart disease (CHD) and stroke among treated individuals living with HIV, while accounting for viral load and known risk factors for cardiovascular diseases and exposure to abacavir or protease inhibitors. We used Cox proportional hazard models with time-dependent cumulative and lagged exposures to account for time-evolving risk factors and avoid reverse causality. CD4, CD8, and CD4:CD8 immunological markers were not associated with an increased hazard for CHD. CD8 cell count lagged at 12 months above 1000 cells per μL increased the hazard of stroke, after adjusting for sociodemographics, cardiovascular risk factors, and exposure to specific types of antiretroviral drugs. This analysis of treated HIV-positive individuals within a large cohort with long-term follow-up does not provide evidence for a prognostic role of immune dysregulation regarding CHD. However, increased CD8 cell count may be a moderate risk factor for stroke. Early detection and treatment of HIV-positive individuals are crucial for an optimal immune restoration and a limited CD8 cells expansion.
Identifiants
pubmed: 36150371
doi: 10.1097/QAI.0000000000003094
pii: 00126334-202212150-00014
pmc: PMC7613804
mid: EMS153908
doi:
Substances chimiques
Anti-Retroviral Agents
0
Biomarkers
0
Anti-HIV Agents
0
Types de publication
Observational Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
508-515Subventions
Organisme : Swiss National Science Foundation
ID : 177499
Pays : Switzerland
Informations de copyright
Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
In the 36 months before the submission of this manuscript, H.C.B. has received grants, support for traveling, consultancy fees and honorarium from Gilead, BMS, Viiv Healthcare, Roche, and Pfizer that were not related to this project. He serves as the president of the association contre le HIV et autres infections transmissibles. In this function, he has received support for the Swiss HIV Cohort Study from ViiV Healthcare, Gilead, BMS, and MSD. The institution of H.F. received educational grants not related to the publication from ViiV, Gilead, MSD, Abbvie, and Sandoz. The institution of M.H. has received consultancy fees from ViiV and Gilead not related to the manuscript. The remaining authors have no funding or conflicts of interest to disclose.
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