Prediction of Liver Disease, AIDS, and Mortality Based on Discordant Absolute and Relative Peripheral CD4 T Lymphocytes in HIV/Hepatitis C Virus-Coinfected Individuals
Hepatitis C virus (HCV)-induced liver fibrosis and splenomegaly may lead to discordance between absolute numbers and percentages of lymphocytes and subpopulations because of sequestration. We investigated lymphocyte discordance in HIV/HCV-coinfected individuals and its relationship to progression to...
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| Veröffentlicht in: | AIDS research and human retroviruses 2018-12, Vol.34 (12), p.1058-1066 |
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| creator | Hansen, Sandra Kronborg, Gitte Benfield, Thomas |
| description | Hepatitis C virus (HCV)-induced liver fibrosis and splenomegaly may lead to discordance between absolute numbers and percentages of lymphocytes and subpopulations because of sequestration. We investigated lymphocyte discordance in HIV/HCV-coinfected individuals and its relationship to progression to liver disease, AIDS, and all-cause mortality. This is an observational retrospective cohort study. Adjusted hazard ratios (aHRs) with 95% confidence intervals (95% CIs) associated with liver disease, AIDS, or mortality were computed by time-updated Cox proportional hazards regression. Of 380 HIV/HCV-coinfected adult individuals followed for a median of 8.2 years, 360 individuals had a median of 11 discordant measurements corresponding to 5,080 of 9,091 paired samples (56%). Discordance alone was not associated with any of the outcomes. By multivariable analysis, a doubling of absolute or percentage CD4 cells was associated with comparable lower risks of mortality (aHR: 0.60, 95% CI: 0.53-0.67, p |
| doi_str_mv | 10.1089/AID.2017.0058 |
| format | Article |
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We investigated lymphocyte discordance in HIV/HCV-coinfected individuals and its relationship to progression to liver disease, AIDS, and all-cause mortality. This is an observational retrospective cohort study. Adjusted hazard ratios (aHRs) with 95% confidence intervals (95% CIs) associated with liver disease, AIDS, or mortality were computed by time-updated Cox proportional hazards regression. Of 380 HIV/HCV-coinfected adult individuals followed for a median of 8.2 years, 360 individuals had a median of 11 discordant measurements corresponding to 5,080 of 9,091 paired samples (56%). Discordance alone was not associated with any of the outcomes. By multivariable analysis, a doubling of absolute or percentage CD4 cells was associated with comparable lower risks of mortality (aHR: 0.60, 95% CI: 0.53-0.67, p < .0001 and aHR: 0.67, 95% CI: 0.56-0.79, p < .0001, respectively). Higher CD4/CD8 ratio was associated with a lower mortality risk (aHR: 0.39, 95% CI: 0.22-0.71 per doubling, p = .002). Only absolute CD4 cell measurements predicted AIDS. Development of liver disease was not predicted by total lymphocyte count or subpopulations. Despite a high prevalence of lymphocyte-subpopulation discordance with HIV/HCV coinfection, absolute CD4 cell count predicted mortality and AIDS, whereas CD4 percentage only predicted mortality. Neither CD4 T lymphocyte count nor CD4 percentage was associated with liver disease in this cohort. These findings may be necessary and useful in countries where antiretroviral treatment is not initiated for all HIV-infected individuals.</description><identifier>ISSN: 0889-2229</identifier><identifier>EISSN: 1931-8405</identifier><identifier>DOI: 10.1089/AID.2017.0058</identifier><identifier>PMID: 30205696</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Acquired immune deficiency syndrome ; AIDS ; Antiretroviral agents ; Antiretroviral drugs ; CD4 antigen ; CD8 antigen ; Cell number ; Confidence intervals ; Discordance ; Fibrosis ; Hazards ; Health risk assessment ; Hepatitis ; Hepatitis C ; HIV ; Human immunodeficiency virus ; Liver ; Liver diseases ; Lymphocytes ; Lymphocytes T ; Mortality ; Predictions ; Regression analysis ; Risk factors ; Splenomegaly ; Statistical analysis ; Subpopulations ; Viruses</subject><ispartof>AIDS research and human retroviruses, 2018-12, Vol.34 (12), p.1058-1066</ispartof><rights>Copyright Mary Ann Liebert, Inc. Dec 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c321t-c31259f8338246845845b7953fea16c0a12132c84128d1a9b36b4cdd343512463</citedby><cites>FETCH-LOGICAL-c321t-c31259f8338246845845b7953fea16c0a12132c84128d1a9b36b4cdd343512463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30205696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hansen, Sandra</creatorcontrib><creatorcontrib>Kronborg, Gitte</creatorcontrib><creatorcontrib>Benfield, Thomas</creatorcontrib><title>Prediction of Liver Disease, AIDS, and Mortality Based on Discordant Absolute and Relative Peripheral CD4 T Lymphocytes in HIV/Hepatitis C Virus-Coinfected Individuals</title><title>AIDS research and human retroviruses</title><addtitle>AIDS Res Hum Retroviruses</addtitle><description>Hepatitis C virus (HCV)-induced liver fibrosis and splenomegaly may lead to discordance between absolute numbers and percentages of lymphocytes and subpopulations because of sequestration. We investigated lymphocyte discordance in HIV/HCV-coinfected individuals and its relationship to progression to liver disease, AIDS, and all-cause mortality. This is an observational retrospective cohort study. Adjusted hazard ratios (aHRs) with 95% confidence intervals (95% CIs) associated with liver disease, AIDS, or mortality were computed by time-updated Cox proportional hazards regression. Of 380 HIV/HCV-coinfected adult individuals followed for a median of 8.2 years, 360 individuals had a median of 11 discordant measurements corresponding to 5,080 of 9,091 paired samples (56%). Discordance alone was not associated with any of the outcomes. By multivariable analysis, a doubling of absolute or percentage CD4 cells was associated with comparable lower risks of mortality (aHR: 0.60, 95% CI: 0.53-0.67, p < .0001 and aHR: 0.67, 95% CI: 0.56-0.79, p < .0001, respectively). Higher CD4/CD8 ratio was associated with a lower mortality risk (aHR: 0.39, 95% CI: 0.22-0.71 per doubling, p = .002). Only absolute CD4 cell measurements predicted AIDS. Development of liver disease was not predicted by total lymphocyte count or subpopulations. Despite a high prevalence of lymphocyte-subpopulation discordance with HIV/HCV coinfection, absolute CD4 cell count predicted mortality and AIDS, whereas CD4 percentage only predicted mortality. Neither CD4 T lymphocyte count nor CD4 percentage was associated with liver disease in this cohort. These findings may be necessary and useful in countries where antiretroviral treatment is not initiated for all HIV-infected individuals.</description><subject>Acquired immune deficiency syndrome</subject><subject>AIDS</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>CD4 antigen</subject><subject>CD8 antigen</subject><subject>Cell number</subject><subject>Confidence intervals</subject><subject>Discordance</subject><subject>Fibrosis</subject><subject>Hazards</subject><subject>Health risk assessment</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Mortality</subject><subject>Predictions</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>Splenomegaly</subject><subject>Statistical analysis</subject><subject>Subpopulations</subject><subject>Viruses</subject><issn>0889-2229</issn><issn>1931-8405</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpdkU1v1DAQhi0EokvhyBVZ4sKh2fojztrHJQvsSouooPQaOfFEdZWNU9uptL-Iv8ksLRyQLM9hHj_2-CXkLWdLzrS5XO82S8H4asmY0s_IghvJC10y9ZwsmNamEEKYM_IqpTvGmBFCvSRnkgmmKlMtyK-rCM532YeRhp7u_QNEuvEJbIILivIfF9SOjn4NMdvB5yP9iB1HEUeqC9HZMdN1m8IwZ_iDfofBZvTQK4h-uoVoB1pvSnpN98fDdBu6Y4ZE_Ui3u5vLLUwIZ59oTW98nFNRBz_20GW8ZDc6_-DdbIf0mrzoscCbp3pOfn7-dF1vi_23L7t6vS86KXjGnQtlei2lFmWlS4WrXRkle7C86pjlgkvR6ZIL7bg1razasnNOllJxPCHPyYdH7xTD_QwpNwccE4bBjhDm1AjOBH5iVZWIvv8PvQtzHPF1SCnUqRXXSBWPVBdDShH6Zor-YOOx4aw5JdhY75pTgs0pQeTfPVnn9gDuH_03MvkbclCUrA</recordid><startdate>20181201</startdate><enddate>20181201</enddate><creator>Hansen, Sandra</creator><creator>Kronborg, Gitte</creator><creator>Benfield, Thomas</creator><general>Mary Ann Liebert, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20181201</creationdate><title>Prediction of Liver Disease, AIDS, and Mortality Based on Discordant Absolute and Relative Peripheral CD4 T Lymphocytes in HIV/Hepatitis C Virus-Coinfected Individuals</title><author>Hansen, Sandra ; Kronborg, Gitte ; Benfield, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c321t-c31259f8338246845845b7953fea16c0a12132c84128d1a9b36b4cdd343512463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>AIDS</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>CD4 antigen</topic><topic>CD8 antigen</topic><topic>Cell number</topic><topic>Confidence intervals</topic><topic>Discordance</topic><topic>Fibrosis</topic><topic>Hazards</topic><topic>Health risk assessment</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Liver</topic><topic>Liver diseases</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Mortality</topic><topic>Predictions</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>Splenomegaly</topic><topic>Statistical analysis</topic><topic>Subpopulations</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hansen, Sandra</creatorcontrib><creatorcontrib>Kronborg, Gitte</creatorcontrib><creatorcontrib>Benfield, Thomas</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>AIDS research and human retroviruses</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hansen, Sandra</au><au>Kronborg, Gitte</au><au>Benfield, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of Liver Disease, AIDS, and Mortality Based on Discordant Absolute and Relative Peripheral CD4 T Lymphocytes in HIV/Hepatitis C Virus-Coinfected Individuals</atitle><jtitle>AIDS research and human retroviruses</jtitle><addtitle>AIDS Res Hum Retroviruses</addtitle><date>2018-12-01</date><risdate>2018</risdate><volume>34</volume><issue>12</issue><spage>1058</spage><epage>1066</epage><pages>1058-1066</pages><issn>0889-2229</issn><eissn>1931-8405</eissn><abstract>Hepatitis C virus (HCV)-induced liver fibrosis and splenomegaly may lead to discordance between absolute numbers and percentages of lymphocytes and subpopulations because of sequestration. We investigated lymphocyte discordance in HIV/HCV-coinfected individuals and its relationship to progression to liver disease, AIDS, and all-cause mortality. This is an observational retrospective cohort study. Adjusted hazard ratios (aHRs) with 95% confidence intervals (95% CIs) associated with liver disease, AIDS, or mortality were computed by time-updated Cox proportional hazards regression. Of 380 HIV/HCV-coinfected adult individuals followed for a median of 8.2 years, 360 individuals had a median of 11 discordant measurements corresponding to 5,080 of 9,091 paired samples (56%). Discordance alone was not associated with any of the outcomes. By multivariable analysis, a doubling of absolute or percentage CD4 cells was associated with comparable lower risks of mortality (aHR: 0.60, 95% CI: 0.53-0.67, p < .0001 and aHR: 0.67, 95% CI: 0.56-0.79, p < .0001, respectively). Higher CD4/CD8 ratio was associated with a lower mortality risk (aHR: 0.39, 95% CI: 0.22-0.71 per doubling, p = .002). Only absolute CD4 cell measurements predicted AIDS. Development of liver disease was not predicted by total lymphocyte count or subpopulations. Despite a high prevalence of lymphocyte-subpopulation discordance with HIV/HCV coinfection, absolute CD4 cell count predicted mortality and AIDS, whereas CD4 percentage only predicted mortality. Neither CD4 T lymphocyte count nor CD4 percentage was associated with liver disease in this cohort. These findings may be necessary and useful in countries where antiretroviral treatment is not initiated for all HIV-infected individuals.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>30205696</pmid><doi>10.1089/AID.2017.0058</doi><tpages>9</tpages></addata></record> |
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| source | Alma/SFX Local Collection |
| subjects | Acquired immune deficiency syndrome AIDS Antiretroviral agents Antiretroviral drugs CD4 antigen CD8 antigen Cell number Confidence intervals Discordance Fibrosis Hazards Health risk assessment Hepatitis Hepatitis C HIV Human immunodeficiency virus Liver Liver diseases Lymphocytes Lymphocytes T Mortality Predictions Regression analysis Risk factors Splenomegaly Statistical analysis Subpopulations Viruses |
| title | Prediction of Liver Disease, AIDS, and Mortality Based on Discordant Absolute and Relative Peripheral CD4 T Lymphocytes in HIV/Hepatitis C Virus-Coinfected Individuals |
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