Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events
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. We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretrovir...
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| Veröffentlicht in: | EBioMedicine 2023-09, Vol.95, p.104773-104773, Article 104773 |
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| creator | Ron, Raquel Olalla, Julián Navarro, M. Luisa González, M. Isabel Garcia, Federico Rubio, Rafael Moreno, Cristina Izquierdo, Rebeca García, Gema Pérez, Verónica Hernández, Jehovana Alemán, M. Remedios Bisbal, Otilia Aramburu, M. José Bustinduy, M. Jesús Padilla, Sergio Adsuar, Araceli Galiana, Antonio Pascual, Reyes Gutierrez, Isabel Ramírez, Margarita Padilla, Belén Tejerina, Francisco Corral, Saray Martí, Anna Peraire, Joaquín Olona, Montserrat Rull, Anna Yeregui, Elena Cuéllar, Sandra Segarra, Inmaculada González-García, Juan Delgado, Ana Castro, Juan Miguel Herranz, Pedro García-Bujalance, Silvia Pérez-Valero, Ignacio Rúa, Guadalupe Sainz, Talía Busca, Carmen Cardiñanos, Julen Sanmartí, Montse Xercavins, Mariona Aiello, Francesco Goikoetxea, Maider Navarro, Gemma Calvet, Marta Moreno, Santiago Moreno, Ana Bernal, Enrique Alcaraz, Antonia Muñoz, Ángeles Chueca, Natalia Vinuesa, David de Salazar, Adolfo Viñuela, Laura Anguita, Francisco Del Romero, Jorge Raposo, Montserrat Carrió, Juan Carlos Antela, Antonio Ribas, M. Angels Vilchez, Helem H. Santos, Jesús López-Cortés, Luis Fernando Llaves, Silvia Imaz, Arkaitz Saumoy, María Descalzo, Vicente Rodríguez, Lucía Olalla, Julián Pérez, Javier Prada, José Luis Pernas, Berta Vázquez, Pilar Mirena, Josu Ferrero, Oscar Luis Peña, Mireia de la Polo, Victor Albendin, Helena Vidal, Asunción Pasquau, Francisco González-Ruano, Patricia Ruiz, M. Pilar Pascual, José Francisco López, M. Villa Alberto de Zarraga, Miguel Cabello, Noemí Carrillo, Irene Arranz, Alberto Novella, María Ferrer, Ana Ruíz, Inma Cervero, Miguel Torres, Rafael Macías, Juan Real, Luis Miguel Pousada, Guillermo Gutiérrez, Sara Tapia, Elena |
| description | 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.
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.
The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio |
| doi_str_mv | 10.1016/j.ebiom.2023.104773 |
| format | Article |
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Luisa ; González, M. Isabel ; Garcia, Federico ; Rubio, Rafael ; Moreno, Cristina ; Izquierdo, Rebeca ; García, Gema ; Pérez, Verónica ; Hernández, Jehovana ; Alemán, M. Remedios ; Bisbal, Otilia ; Aramburu, M. José ; Bustinduy, M. Jesús ; Padilla, Sergio ; Adsuar, Araceli ; Galiana, Antonio ; Pascual, Reyes ; Gutierrez, Isabel ; Ramírez, Margarita ; Padilla, Belén ; Tejerina, Francisco ; Corral, Saray ; Martí, Anna ; Peraire, Joaquín ; Olona, Montserrat ; Rull, Anna ; Yeregui, Elena ; Cuéllar, Sandra ; Segarra, Inmaculada ; González-García, Juan ; Delgado, Ana ; Castro, Juan Miguel ; Herranz, Pedro ; García-Bujalance, Silvia ; Pérez-Valero, Ignacio ; Rúa, Guadalupe ; Sainz, Talía ; Busca, Carmen ; Cardiñanos, Julen ; Sanmartí, Montse ; Xercavins, Mariona ; Aiello, Francesco ; Goikoetxea, Maider ; Navarro, Gemma ; Calvet, Marta ; Moreno, Santiago ; Moreno, Ana ; Bernal, Enrique ; Alcaraz, Antonia ; Muñoz, Ángeles ; Chueca, Natalia ; Vinuesa, David ; de Salazar, Adolfo ; Viñuela, Laura ; Anguita, Francisco ; Del Romero, Jorge ; Raposo, Montserrat ; Carrió, Juan Carlos ; Antela, Antonio ; Ribas, M. Angels ; Vilchez, Helem H. ; Santos, Jesús ; López-Cortés, Luis Fernando ; Llaves, Silvia ; Imaz, Arkaitz ; Saumoy, María ; Descalzo, Vicente ; Rodríguez, Lucía ; Olalla, Julián ; Pérez, Javier ; Prada, José Luis ; Pernas, Berta ; Vázquez, Pilar ; Mirena, Josu ; Ferrero, Oscar Luis ; Peña, Mireia de la ; Polo, Victor ; Albendin, Helena ; Vidal, Asunción ; Pasquau, Francisco ; González-Ruano, Patricia ; Ruiz, M. Pilar ; Pascual, José Francisco ; López, M. Villa ; Alberto de Zarraga, Miguel ; Cabello, Noemí ; Carrillo, Irene ; Arranz, Alberto ; Novella, María ; Ferrer, Ana ; Ruíz, Inma ; Cervero, Miguel ; Torres, Rafael ; Macías, Juan ; Real, Luis Miguel ; Pousada, Guillermo ; Gutiérrez, Sara ; Tapia, Elena</creator><creatorcontrib>Ron, Raquel ; Olalla, Julián ; Navarro, M. Luisa ; González, M. Isabel ; Garcia, Federico ; Rubio, Rafael ; Moreno, Cristina ; Izquierdo, Rebeca ; García, Gema ; Pérez, Verónica ; Hernández, Jehovana ; Alemán, M. Remedios ; Bisbal, Otilia ; Aramburu, M. José ; Bustinduy, M. Jesús ; Padilla, Sergio ; Adsuar, Araceli ; Galiana, Antonio ; Pascual, Reyes ; Gutierrez, Isabel ; Ramírez, Margarita ; Padilla, Belén ; Tejerina, Francisco ; Corral, Saray ; Martí, Anna ; Peraire, Joaquín ; Olona, Montserrat ; Rull, Anna ; Yeregui, Elena ; Cuéllar, Sandra ; Segarra, Inmaculada ; González-García, Juan ; Delgado, Ana ; Castro, Juan Miguel ; Herranz, Pedro ; García-Bujalance, Silvia ; Pérez-Valero, Ignacio ; Rúa, Guadalupe ; Sainz, Talía ; Busca, Carmen ; Cardiñanos, Julen ; Sanmartí, Montse ; Xercavins, Mariona ; Aiello, Francesco ; Goikoetxea, Maider ; Navarro, Gemma ; Calvet, Marta ; Moreno, Santiago ; Moreno, Ana ; Bernal, Enrique ; Alcaraz, Antonia ; Muñoz, Ángeles ; Chueca, Natalia ; Vinuesa, David ; de Salazar, Adolfo ; Viñuela, Laura ; Anguita, Francisco ; Del Romero, Jorge ; Raposo, Montserrat ; Carrió, Juan Carlos ; Antela, Antonio ; Ribas, M. Angels ; Vilchez, Helem H. ; Santos, Jesús ; López-Cortés, Luis Fernando ; Llaves, Silvia ; Imaz, Arkaitz ; Saumoy, María ; Descalzo, Vicente ; Rodríguez, Lucía ; Olalla, Julián ; Pérez, Javier ; Prada, José Luis ; Pernas, Berta ; Vázquez, Pilar ; Mirena, Josu ; Ferrero, Oscar Luis ; Peña, Mireia de la ; Polo, Victor ; Albendin, Helena ; Vidal, Asunción ; Pasquau, Francisco ; González-Ruano, Patricia ; Ruiz, M. Pilar ; Pascual, José Francisco ; López, M. Villa ; Alberto de Zarraga, Miguel ; Cabello, Noemí ; Carrillo, Irene ; Arranz, Alberto ; Novella, María ; Ferrer, Ana ; Ruíz, Inma ; Cervero, Miguel ; Torres, Rafael ; Macías, Juan ; Real, Luis Miguel ; Pousada, Guillermo ; Gutiérrez, Sara ; Tapia, Elena ; CoRIS</creatorcontrib><description>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.
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.
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/μL predicted an increased risk of clinical events. Among participants with a CD4 count ≥500 cells/μL, a CD8 count ≥1500 cells/μL or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.
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/μL, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.
This work was supported by CIBER (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU; by the Spanish AIDS Research Network (RIS) RD16/0025/0001 project as part of the Plan Nacional R + D + I, and cofinanced by Instituto de Salud Carlos III (ISCIII)- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER), ISCIII projects PI18/00154, PI21/00141, and ERDF, “A way to make Europe”, ICI20/00058.</description><identifier>ISSN: 2352-3964</identifier><identifier>EISSN: 2352-3964</identifier><identifier>DOI: 10.1016/j.ebiom.2023.104773</identifier><language>eng</language><publisher>Elsevier B.V</publisher><subject>Cardiovascular event ; CD4/CD8 ratio ; HIV ; Neoplasia ; Non-AIDS events</subject><ispartof>EBioMedicine, 2023-09, Vol.95, p.104773-104773, Article 104773</ispartof><rights>2023 The Author(s)</rights><rights>2023 The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c437t-c9eb75a6da8d8e00d2fa4a71878e1bbd3c00b46ecaef8e7d9935c0e74d5c65ea3</citedby><cites>FETCH-LOGICAL-c437t-c9eb75a6da8d8e00d2fa4a71878e1bbd3c00b46ecaef8e7d9935c0e74d5c65ea3</cites><orcidid>0000-0003-2020-3908 ; 0000-0002-9017-1174</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474064/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10474064/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids></links><search><creatorcontrib>Ron, Raquel</creatorcontrib><creatorcontrib>Olalla, Julián</creatorcontrib><creatorcontrib>Navarro, M. 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Pilar</creatorcontrib><creatorcontrib>Pascual, José Francisco</creatorcontrib><creatorcontrib>López, M. Villa</creatorcontrib><creatorcontrib>Alberto de Zarraga, Miguel</creatorcontrib><creatorcontrib>Cabello, Noemí</creatorcontrib><creatorcontrib>Carrillo, Irene</creatorcontrib><creatorcontrib>Arranz, Alberto</creatorcontrib><creatorcontrib>Novella, María</creatorcontrib><creatorcontrib>Ferrer, Ana</creatorcontrib><creatorcontrib>Ruíz, Inma</creatorcontrib><creatorcontrib>Cervero, Miguel</creatorcontrib><creatorcontrib>Torres, Rafael</creatorcontrib><creatorcontrib>Macías, Juan</creatorcontrib><creatorcontrib>Real, Luis Miguel</creatorcontrib><creatorcontrib>Pousada, Guillermo</creatorcontrib><creatorcontrib>Gutiérrez, Sara</creatorcontrib><creatorcontrib>Tapia, Elena</creatorcontrib><creatorcontrib>CoRIS</creatorcontrib><title>Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events</title><title>EBioMedicine</title><description>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.
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.
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/μL predicted an increased risk of clinical events. Among participants with a CD4 count ≥500 cells/μL, a CD8 count ≥1500 cells/μL or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.
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/μL, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.
This work was supported by CIBER (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU; by the Spanish AIDS Research Network (RIS) RD16/0025/0001 project as part of the Plan Nacional R + D + I, and cofinanced by Instituto de Salud Carlos III (ISCIII)- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER), ISCIII projects PI18/00154, PI21/00141, and ERDF, “A way to make Europe”, ICI20/00058.</description><subject>Cardiovascular event</subject><subject>CD4/CD8 ratio</subject><subject>HIV</subject><subject>Neoplasia</subject><subject>Non-AIDS events</subject><issn>2352-3964</issn><issn>2352-3964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9UU1LxDAUDKKgrPsLvOTowa5pk7apICK7fiwIHvy4hjR53c3SJmvSXfTfm7oievGSlzfJzMAMQicpmaQkLc5XE6iN6yYZyWhEWFnSPXSU0TxLaFWw_V_3QzQOYUUISXMWQX6Eljfva2m1sQt8P3_FqjXWKNnizlnTOx_xC9wvAXvXAnYNns7YWTz4GY6sYTuPC_ayNw4bi9cetFH9IGedTa7nsycMW7B9OEYHjWwDjL_nCL3c3jxP75OHx7v59PohUYyWfaIqqMtcFlpyzYEQnTWSyTLlJYe0rjVVhNSsACWh4VDqqqK5IlAynasiB0lH6Gqnu97UHWgVvb1sxdqbTvoP4aQRf1-sWYqF24ohOUYKFhVOvxW8e9tA6EVngoK2lRbcJoiM57yqMhqtR4juvirvQvDQ_PikRAzliJX4KkcM5YhdOZF1uWNBzGFrwIugDFgVo_OgeqGd-Zf_CSUMmKI</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Ron, Raquel</creator><creator>Olalla, Julián</creator><creator>Navarro, M. 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Luisa ; González, M. Isabel ; Garcia, Federico ; Rubio, Rafael ; Moreno, Cristina ; Izquierdo, Rebeca ; García, Gema ; Pérez, Verónica ; Hernández, Jehovana ; Alemán, M. Remedios ; Bisbal, Otilia ; Aramburu, M. José ; Bustinduy, M. Jesús ; Padilla, Sergio ; Adsuar, Araceli ; Galiana, Antonio ; Pascual, Reyes ; Gutierrez, Isabel ; Ramírez, Margarita ; Padilla, Belén ; Tejerina, Francisco ; Corral, Saray ; Martí, Anna ; Peraire, Joaquín ; Olona, Montserrat ; Rull, Anna ; Yeregui, Elena ; Cuéllar, Sandra ; Segarra, Inmaculada ; González-García, Juan ; Delgado, Ana ; Castro, Juan Miguel ; Herranz, Pedro ; García-Bujalance, Silvia ; Pérez-Valero, Ignacio ; Rúa, Guadalupe ; Sainz, Talía ; Busca, Carmen ; Cardiñanos, Julen ; Sanmartí, Montse ; Xercavins, Mariona ; Aiello, Francesco ; Goikoetxea, Maider ; Navarro, Gemma ; Calvet, Marta ; Moreno, Santiago ; Moreno, Ana ; Bernal, Enrique ; Alcaraz, Antonia ; Muñoz, Ángeles ; Chueca, Natalia ; Vinuesa, David ; de Salazar, Adolfo ; Viñuela, Laura ; Anguita, Francisco ; Del Romero, Jorge ; Raposo, Montserrat ; Carrió, Juan Carlos ; Antela, Antonio ; Ribas, M. Angels ; Vilchez, Helem H. ; Santos, Jesús ; López-Cortés, Luis Fernando ; Llaves, Silvia ; Imaz, Arkaitz ; Saumoy, María ; Descalzo, Vicente ; Rodríguez, Lucía ; Olalla, Julián ; Pérez, Javier ; Prada, José Luis ; Pernas, Berta ; Vázquez, Pilar ; Mirena, Josu ; Ferrero, Oscar Luis ; Peña, Mireia de la ; Polo, Victor ; Albendin, Helena ; Vidal, Asunción ; Pasquau, Francisco ; González-Ruano, Patricia ; Ruiz, M. Pilar ; Pascual, José Francisco ; López, M. Villa ; Alberto de Zarraga, Miguel ; Cabello, Noemí ; Carrillo, Irene ; Arranz, Alberto ; Novella, María ; Ferrer, Ana ; Ruíz, Inma ; Cervero, Miguel ; Torres, Rafael ; Macías, Juan ; Real, Luis Miguel ; Pousada, Guillermo ; Gutiérrez, Sara ; Tapia, Elena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c437t-c9eb75a6da8d8e00d2fa4a71878e1bbd3c00b46ecaef8e7d9935c0e74d5c65ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiovascular event</topic><topic>CD4/CD8 ratio</topic><topic>HIV</topic><topic>Neoplasia</topic><topic>Non-AIDS events</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ron, Raquel</creatorcontrib><creatorcontrib>Olalla, Julián</creatorcontrib><creatorcontrib>Navarro, M. Luisa</creatorcontrib><creatorcontrib>González, M. Isabel</creatorcontrib><creatorcontrib>Garcia, Federico</creatorcontrib><creatorcontrib>Rubio, Rafael</creatorcontrib><creatorcontrib>Moreno, Cristina</creatorcontrib><creatorcontrib>Izquierdo, Rebeca</creatorcontrib><creatorcontrib>García, Gema</creatorcontrib><creatorcontrib>Pérez, Verónica</creatorcontrib><creatorcontrib>Hernández, Jehovana</creatorcontrib><creatorcontrib>Alemán, M. Remedios</creatorcontrib><creatorcontrib>Bisbal, Otilia</creatorcontrib><creatorcontrib>Aramburu, M. José</creatorcontrib><creatorcontrib>Bustinduy, M. 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Angels</creatorcontrib><creatorcontrib>Vilchez, Helem H.</creatorcontrib><creatorcontrib>Santos, Jesús</creatorcontrib><creatorcontrib>López-Cortés, Luis Fernando</creatorcontrib><creatorcontrib>Llaves, Silvia</creatorcontrib><creatorcontrib>Imaz, Arkaitz</creatorcontrib><creatorcontrib>Saumoy, María</creatorcontrib><creatorcontrib>Descalzo, Vicente</creatorcontrib><creatorcontrib>Rodríguez, Lucía</creatorcontrib><creatorcontrib>Olalla, Julián</creatorcontrib><creatorcontrib>Pérez, Javier</creatorcontrib><creatorcontrib>Prada, José Luis</creatorcontrib><creatorcontrib>Pernas, Berta</creatorcontrib><creatorcontrib>Vázquez, Pilar</creatorcontrib><creatorcontrib>Mirena, Josu</creatorcontrib><creatorcontrib>Ferrero, Oscar Luis</creatorcontrib><creatorcontrib>Peña, Mireia de la</creatorcontrib><creatorcontrib>Polo, Victor</creatorcontrib><creatorcontrib>Albendin, Helena</creatorcontrib><creatorcontrib>Vidal, Asunción</creatorcontrib><creatorcontrib>Pasquau, Francisco</creatorcontrib><creatorcontrib>González-Ruano, Patricia</creatorcontrib><creatorcontrib>Ruiz, M. Pilar</creatorcontrib><creatorcontrib>Pascual, José Francisco</creatorcontrib><creatorcontrib>López, M. Villa</creatorcontrib><creatorcontrib>Alberto de Zarraga, Miguel</creatorcontrib><creatorcontrib>Cabello, Noemí</creatorcontrib><creatorcontrib>Carrillo, Irene</creatorcontrib><creatorcontrib>Arranz, Alberto</creatorcontrib><creatorcontrib>Novella, María</creatorcontrib><creatorcontrib>Ferrer, Ana</creatorcontrib><creatorcontrib>Ruíz, Inma</creatorcontrib><creatorcontrib>Cervero, Miguel</creatorcontrib><creatorcontrib>Torres, Rafael</creatorcontrib><creatorcontrib>Macías, Juan</creatorcontrib><creatorcontrib>Real, Luis Miguel</creatorcontrib><creatorcontrib>Pousada, Guillermo</creatorcontrib><creatorcontrib>Gutiérrez, Sara</creatorcontrib><creatorcontrib>Tapia, Elena</creatorcontrib><creatorcontrib>CoRIS</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>EBioMedicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ron, Raquel</au><au>Olalla, Julián</au><au>Navarro, M. Luisa</au><au>González, M. Isabel</au><au>Garcia, Federico</au><au>Rubio, Rafael</au><au>Moreno, Cristina</au><au>Izquierdo, Rebeca</au><au>García, Gema</au><au>Pérez, Verónica</au><au>Hernández, Jehovana</au><au>Alemán, M. Remedios</au><au>Bisbal, Otilia</au><au>Aramburu, M. José</au><au>Bustinduy, M. Jesús</au><au>Padilla, Sergio</au><au>Adsuar, Araceli</au><au>Galiana, Antonio</au><au>Pascual, Reyes</au><au>Gutierrez, Isabel</au><au>Ramírez, Margarita</au><au>Padilla, Belén</au><au>Tejerina, Francisco</au><au>Corral, Saray</au><au>Martí, Anna</au><au>Peraire, Joaquín</au><au>Olona, Montserrat</au><au>Rull, Anna</au><au>Yeregui, Elena</au><au>Cuéllar, Sandra</au><au>Segarra, Inmaculada</au><au>González-García, Juan</au><au>Delgado, Ana</au><au>Castro, Juan Miguel</au><au>Herranz, Pedro</au><au>García-Bujalance, Silvia</au><au>Pérez-Valero, Ignacio</au><au>Rúa, Guadalupe</au><au>Sainz, Talía</au><au>Busca, Carmen</au><au>Cardiñanos, Julen</au><au>Sanmartí, Montse</au><au>Xercavins, Mariona</au><au>Aiello, Francesco</au><au>Goikoetxea, Maider</au><au>Navarro, Gemma</au><au>Calvet, Marta</au><au>Moreno, Santiago</au><au>Moreno, Ana</au><au>Bernal, Enrique</au><au>Alcaraz, Antonia</au><au>Muñoz, Ángeles</au><au>Chueca, Natalia</au><au>Vinuesa, David</au><au>de Salazar, Adolfo</au><au>Viñuela, Laura</au><au>Anguita, Francisco</au><au>Del Romero, Jorge</au><au>Raposo, Montserrat</au><au>Carrió, Juan Carlos</au><au>Antela, Antonio</au><au>Ribas, M. Angels</au><au>Vilchez, Helem H.</au><au>Santos, Jesús</au><au>López-Cortés, Luis Fernando</au><au>Llaves, Silvia</au><au>Imaz, Arkaitz</au><au>Saumoy, María</au><au>Descalzo, Vicente</au><au>Rodríguez, Lucía</au><au>Olalla, Julián</au><au>Pérez, Javier</au><au>Prada, José Luis</au><au>Pernas, Berta</au><au>Vázquez, Pilar</au><au>Mirena, Josu</au><au>Ferrero, Oscar Luis</au><au>Peña, Mireia de la</au><au>Polo, Victor</au><au>Albendin, Helena</au><au>Vidal, Asunción</au><au>Pasquau, Francisco</au><au>González-Ruano, Patricia</au><au>Ruiz, M. Pilar</au><au>Pascual, José Francisco</au><au>López, M. Villa</au><au>Alberto de Zarraga, Miguel</au><au>Cabello, Noemí</au><au>Carrillo, Irene</au><au>Arranz, Alberto</au><au>Novella, María</au><au>Ferrer, Ana</au><au>Ruíz, Inma</au><au>Cervero, Miguel</au><au>Torres, Rafael</au><au>Macías, Juan</au><au>Real, Luis Miguel</au><au>Pousada, Guillermo</au><au>Gutiérrez, Sara</au><au>Tapia, Elena</au><aucorp>CoRIS</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events</atitle><jtitle>EBioMedicine</jtitle><date>2023-09-01</date><risdate>2023</risdate><volume>95</volume><spage>104773</spage><epage>104773</epage><pages>104773-104773</pages><artnum>104773</artnum><issn>2352-3964</issn><eissn>2352-3964</eissn><abstract>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.
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.
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/μL predicted an increased risk of clinical events. Among participants with a CD4 count ≥500 cells/μL, a CD8 count ≥1500 cells/μL or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.
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/μL, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.
This work was supported by CIBER (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU; by the Spanish AIDS Research Network (RIS) RD16/0025/0001 project as part of the Plan Nacional R + D + I, and cofinanced by Instituto de Salud Carlos III (ISCIII)- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER), ISCIII projects PI18/00154, PI21/00141, and ERDF, “A way to make Europe”, ICI20/00058.</abstract><pub>Elsevier B.V</pub><doi>10.1016/j.ebiom.2023.104773</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-2020-3908</orcidid><orcidid>https://orcid.org/0000-0002-9017-1174</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2352-3964 |
| ispartof | EBioMedicine, 2023-09, Vol.95, p.104773-104773, Article 104773 |
| issn | 2352-3964 2352-3964 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10474064 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Cardiovascular event CD4/CD8 ratio HIV Neoplasia Non-AIDS events |
| title | Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events |
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