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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

Journal of acquired immune deficiency syndromes (1999), 2022-12, Vol.91 (5), p.508-515 [Peer Reviewed Journal]

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. ;Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. 2022 ;ISSN: 1525-4135 ;EISSN: 1944-7884 ;DOI: 10.1097/QAI.0000000000003094 ;PMID: 36150371

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Title:
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
Author: Chammartin, Frédérique ; Darling, Katharine ; Abela, Irene A ; Battegay, Manuel ; Furrer, Hansjakob ; Calmy, Alexandra ; Bernasconi, Enos ; Schmid, Patrick ; Hoffmann, Matthias ; Bucher, Heiner C
Subjects: Abacavir ; Anti-HIV Agents - adverse effects ; Anti-Retroviral Agents - adverse effects ; Antiretroviral agents ; Antiretroviral therapy ; Biomarkers ; Cardiovascular disease ; Cardiovascular diseases ; Cardiovascular Diseases - drug therapy ; CD4 antigen ; CD4 Lymphocyte Count ; CD4-CD8 Ratio ; CD4-Positive T-Lymphocytes ; CD8 antigen ; CD8-Positive T-Lymphocytes ; Clinical Science ; Cohort analysis ; Cohort Studies ; Coronary artery disease ; Coronary Disease - epidemiology ; Exposure ; Health hazards ; Health risks ; Heart diseases ; Helper cells ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Immunology ; Immunosuppressive agents ; Lymphocytes ; Lymphocytes T ; Markers ; Prognosis ; Protease inhibitors ; Proteinase inhibitors ; Risk analysis ; Risk factors ; Statistical models ; Stroke ; Stroke - epidemiology ; Suppressor cells ; Switzerland ; Time dependence ; Viral Load
Is Part Of: Journal of acquired immune deficiency syndromes (1999), 2022-12, Vol.91 (5), p.508-515
Description: 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.
Publisher: United States: Lippincott Williams & Wilkins Ovid Technologies
Language: English
Identifier: ISSN: 1525-4135
EISSN: 1944-7884
DOI: 10.1097/QAI.0000000000003094
PMID: 36150371
Source: MEDLINE
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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

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