The CD4/CD8 ratio in HIV-infected subjects is independently associated with T-cell activation despite long-term viral suppression

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• 作者：Sergio Serrano-Villar^a ; ^d ; ^{serranovillar@gmail.com} ; Carolina Gutié ; rrez^a ; ^d ; Alejandro Vallejo^a ; ^d ; Beatriz Hern&#225 ; ndez-Novoa^a ; ^d ; Laura Dí ; az^b ; Marí ; a Abad Fern&#225 ; ndez^a ; ^d ; Nadia Madrid^a ; ^d ; Fernando Dronda^a ; Javier Zamora^c ; ^d ; Marí ; a Á ; ngeles Muñ ; oz-Fern&#225 ; ndez^b ; Santiago Moreno^a ; ^d ; ^{smoreno.hrc@salud.madrid.org}
• 关键词：HIV ; CD4/CD8 ratio ; Immune activation ; Immunosenescence ; Bacterial translocation ; HIV-1 latent reservoir ; CD4 count
• 刊名：Journal of Infection
• 出版年：2013
• 出版时间：January, 2013
• 年：2013
• 卷：66
• 期：1
• 页码：57-66
• 全文大小：635 K

文摘

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Summary

Objectives

HIV-infected subjects on antiretroviral therapy often fail to normalize the CD4/CD8 ratio despite CD4 count normalization. We aimed to analyze the biological significance of this finding.

Methods

Cross-sectional analysis in 20 HIV-infected subjects on stable triple-ART, plasma HIV RNA <40?copies/mL for at least 2 years and CD4 count >350?cells/mm³. Laboratory measurements included T-cell activation (HLADR⁺, CD38⁺) and senescence (CD57⁺), lipopolysaccharide (LPS), sCD14 and the HIV latent reservoir (number of latently infected memory CD4 cells carrying replication-competent virus).

Results

CD4/CD8 ratio was positively correlated with CD4 nadir (m>rm>?=?0.468, m>pm>?=?0.038) and accumulated ART exposure (m>rm>?=?0.554, m>pm>?=?0.0011), and negatively with viral load before ART initiation (m>rm>?=??0.547, m>pm>?=?0.013), CD4⁺HLADR⁺CD38⁺ T-cells (m>rm>?=??0.428, m>pm>?=?0.086) and CD8⁺CD57⁺ T-cells (m>rm>?=??0.431, m>pm>?=?0.084). No associations with LPS, sCD14 or HIV latent reservoir were found. After the multivariate analyses, the CD4/CD8 ratio remained independently associated with CD4⁺HLADR⁺CD38⁺ T-cells and CD8⁺HLADR⁺ T-cells.

Conclusions

In our study in subjects on suppressive ART the CD4/CD8 ratio was independently associated with T-cell activation. Our results must be confirmed in larger studies, as this parameter might be a useful clinical tool to identify subjects with ongoing immune activation despite long-term viral suppression.