Maria J Vivancos-Gallego, Hajra Okhai, Maria J Perez-Elías, Cristina Gomez-Ayerbe, Ana Moreno-Zamora, Jose L Casado, Carmen Quereda, Javier Martinez Sanz, Matilde Sanchez-Conde, Sergio Serrano-Villar, Santos Del Campo, Fernando Dronda, Juan Carlos Galan, Caroline A Sabin, Santiago Moreno
{"title":"接受抗逆转录病毒治疗的艾滋病毒感染者CD4+:CD8+ t细胞比率的变化。","authors":"Maria J Vivancos-Gallego, Hajra Okhai, Maria J Perez-Elías, Cristina Gomez-Ayerbe, Ana Moreno-Zamora, Jose L Casado, Carmen Quereda, Javier Martinez Sanz, Matilde Sanchez-Conde, Sergio Serrano-Villar, Santos Del Campo, Fernando Dronda, Juan Carlos Galan, Caroline A Sabin, Santiago Moreno","doi":"10.3851/IMP3354","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cofactors associated with persistently abnormal CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio in people with HIV (PWH) on antiretroviral treatment (ART) might change over time as the population of people with HIV ages or as new ART drugs become available. The main objective of our study was to determine the long-term associations of baseline factors, including the CD4<sup>+</sup> T-cell count and ratio, with ratio normalization (≥1). In addition to this, we explored whether the ratio remained associated with the risk of both AIDS and non-AIDS events among individuals on suppressive ART.</p><p><strong>Methods: </strong>Clinic-based study in a tertiary, university hospital in Madrid. People with HIV starting a first-line ART regimen (January 2006-June 2017) were included in a prospective national multicentre cohort (CoRIS). People with controlled HIV-infection within the first year of ART initiation and complete CD4<sup>+</sup> and CD8<sup>+</sup> T-cell records were selected. Cox proportional hazard (PH) regression models were used to estimate the cumulative incidence of ratio normalization and to examine associations with socio-demographic and clinical variables. To investigate factors independently associated with the development of AIDS and non-AIDS events we used a time updated Poisson regression model.</p><p><strong>Results: </strong>The study included 557 subjects. During follow-up (median 5.24 years), 44% of participants achieved a ratio of 1 within a median of 1.49 years. In a multivariate PH model, pre-ART factors negatively associated with ratio normalization were the pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio and mode of HIV acquisition. For the secondary analysis, 1.3 events/100 person years of follow-up were observed. After adjustment, older age, HIV RNA >200 copies/ml and CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratios over follow-up, remained significantly associated with the development of AIDS and non-AIDS events. In contrast, pre-ART ratio was not associated with the risk of AIDS and non-AIDS events.</p><p><strong>Conclusions: </strong>In summary, our study showed that higher pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio is associated with rates of ratio normalization ≥1. In addition, the risk of AIDS and non-AIDS events seems to be predicted by the time updated CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio not by the pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio. Therefore, CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio should be considered as a dynamic marker for translation into clinical practice.</p>","PeriodicalId":8364,"journal":{"name":"Antiviral Therapy","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":"{\"title\":\"CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio changes in people with HIV receiving antiretroviral treatment.\",\"authors\":\"Maria J Vivancos-Gallego, Hajra Okhai, Maria J Perez-Elías, Cristina Gomez-Ayerbe, Ana Moreno-Zamora, Jose L Casado, Carmen Quereda, Javier Martinez Sanz, Matilde Sanchez-Conde, Sergio Serrano-Villar, Santos Del Campo, Fernando Dronda, Juan Carlos Galan, Caroline A Sabin, Santiago Moreno\",\"doi\":\"10.3851/IMP3354\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cofactors associated with persistently abnormal CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio in people with HIV (PWH) on antiretroviral treatment (ART) might change over time as the population of people with HIV ages or as new ART drugs become available. The main objective of our study was to determine the long-term associations of baseline factors, including the CD4<sup>+</sup> T-cell count and ratio, with ratio normalization (≥1). In addition to this, we explored whether the ratio remained associated with the risk of both AIDS and non-AIDS events among individuals on suppressive ART.</p><p><strong>Methods: </strong>Clinic-based study in a tertiary, university hospital in Madrid. People with HIV starting a first-line ART regimen (January 2006-June 2017) were included in a prospective national multicentre cohort (CoRIS). People with controlled HIV-infection within the first year of ART initiation and complete CD4<sup>+</sup> and CD8<sup>+</sup> T-cell records were selected. Cox proportional hazard (PH) regression models were used to estimate the cumulative incidence of ratio normalization and to examine associations with socio-demographic and clinical variables. To investigate factors independently associated with the development of AIDS and non-AIDS events we used a time updated Poisson regression model.</p><p><strong>Results: </strong>The study included 557 subjects. During follow-up (median 5.24 years), 44% of participants achieved a ratio of 1 within a median of 1.49 years. In a multivariate PH model, pre-ART factors negatively associated with ratio normalization were the pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio and mode of HIV acquisition. For the secondary analysis, 1.3 events/100 person years of follow-up were observed. After adjustment, older age, HIV RNA >200 copies/ml and CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratios over follow-up, remained significantly associated with the development of AIDS and non-AIDS events. In contrast, pre-ART ratio was not associated with the risk of AIDS and non-AIDS events.</p><p><strong>Conclusions: </strong>In summary, our study showed that higher pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio is associated with rates of ratio normalization ≥1. In addition, the risk of AIDS and non-AIDS events seems to be predicted by the time updated CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio not by the pre-ART CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio. Therefore, CD4<sup>+</sup>:CD8<sup>+</sup> T-cell ratio should be considered as a dynamic marker for translation into clinical practice.</p>\",\"PeriodicalId\":8364,\"journal\":{\"name\":\"Antiviral Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2020-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antiviral Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3851/IMP3354\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antiviral Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3851/IMP3354","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
CD4+:CD8+ T-cell ratio changes in people with HIV receiving antiretroviral treatment.
Background: Cofactors associated with persistently abnormal CD4+:CD8+ T-cell ratio in people with HIV (PWH) on antiretroviral treatment (ART) might change over time as the population of people with HIV ages or as new ART drugs become available. The main objective of our study was to determine the long-term associations of baseline factors, including the CD4+ T-cell count and ratio, with ratio normalization (≥1). In addition to this, we explored whether the ratio remained associated with the risk of both AIDS and non-AIDS events among individuals on suppressive ART.
Methods: Clinic-based study in a tertiary, university hospital in Madrid. People with HIV starting a first-line ART regimen (January 2006-June 2017) were included in a prospective national multicentre cohort (CoRIS). People with controlled HIV-infection within the first year of ART initiation and complete CD4+ and CD8+ T-cell records were selected. Cox proportional hazard (PH) regression models were used to estimate the cumulative incidence of ratio normalization and to examine associations with socio-demographic and clinical variables. To investigate factors independently associated with the development of AIDS and non-AIDS events we used a time updated Poisson regression model.
Results: The study included 557 subjects. During follow-up (median 5.24 years), 44% of participants achieved a ratio of 1 within a median of 1.49 years. In a multivariate PH model, pre-ART factors negatively associated with ratio normalization were the pre-ART CD4+:CD8+ T-cell ratio and mode of HIV acquisition. For the secondary analysis, 1.3 events/100 person years of follow-up were observed. After adjustment, older age, HIV RNA >200 copies/ml and CD4+:CD8+ T-cell ratios over follow-up, remained significantly associated with the development of AIDS and non-AIDS events. In contrast, pre-ART ratio was not associated with the risk of AIDS and non-AIDS events.
Conclusions: In summary, our study showed that higher pre-ART CD4+:CD8+ T-cell ratio is associated with rates of ratio normalization ≥1. In addition, the risk of AIDS and non-AIDS events seems to be predicted by the time updated CD4+:CD8+ T-cell ratio not by the pre-ART CD4+:CD8+ T-cell ratio. Therefore, CD4+:CD8+ T-cell ratio should be considered as a dynamic marker for translation into clinical practice.
期刊介绍:
Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases.
The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.