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Coinfection by Hepatitis C Is Strongly Associated with Abnormal CD4/CD8 Ratio in HIV Patients under Stable ART in Salvador, Brazil.

Brites-Alves C, Netto EM, Brites C - J Immunol Res (2015)

Bottom Line: Male gender (p < 0.01), lower mean CD4 nadir (p < 0.001), higher baseline VL (p = 0.01), previous diagnosis of Tb (p = 0.03), or HCV (p < 0.01) was associated with IR.Longer time under suppressive ART was also associated with a greater chance of AR, but logistic regression identified coinfection by HCV as the main factor associated with abnormal CD4/CD8 ratio.Previous HCV diagnosis significantly increases the risk of abnormal CD4/CD8 ratio.

View Article: PubMed Central - PubMed

Affiliation: Laboratorio de Pesquisas em Infectologia, Complexo Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.

ABSTRACT

Unlabelled: Proper immune restoration (CD4 count >500 and normal CD4/8 ratio) is reached only by a fraction of HIV patients, despite stable viral suppression.

Methods: We present a case-control study to compare HIV patients with viral suppression >1 year, according to immune restoration pattern: adequate response (AR) defined by CD4 > 500 cells/mm(3) and CD4/8 ratio >1; partial response (PR = patients with CD4 > 500, but CD4/8 ratio <1); inadequate response (IR = CD4 < 500 cells).

Results: We evaluated 293 consecutive patients (89 AR, 112 PR, and 92 IR), 70% males. Male gender (p < 0.01), lower mean CD4 nadir (p < 0.001), higher baseline VL (p = 0.01), previous diagnosis of Tb (p = 0.03), or HCV (p < 0.01) was associated with IR. Likelihood of AR/PR was similar regardless of gender, after adjusting for nadir CD4+ cells count. Longer time under suppressive ART was also associated with a greater chance of AR, but logistic regression identified coinfection by HCV as the main factor associated with abnormal CD4/CD8 ratio.

Conclusion: Early initiation of ART and longer time since first undetectable PVL were predictors of AR. Previous HCV diagnosis significantly increases the risk of abnormal CD4/CD8 ratio.

No MeSH data available.


Related in: MedlinePlus

Proportion of patients reaching inadequate, partial, or adequate immune restoration, according to mean CD4 count nadir.
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fig1: Proportion of patients reaching inadequate, partial, or adequate immune restoration, according to mean CD4 count nadir.

Mentions: Mean follow-up duration was 1804 ± 1189 days. Table 1 displays the main demographic characteristics of groups. We detected a higher proportion of MSM patients presenting with inadequate immune restoration in comparison with subjects infected by heterosexual contact, but it did not reach statistical significance. In addition, women were more likely to achieve AR than men, but they had mean CD4 count nadir significantly higher than that observed for men (264.7 ± 176.6 cells/mm3 versus 209.8 ± 190.5, resp., p < 0.001). Figure 1 displays the distribution of groups across different CD4 strata.


Coinfection by Hepatitis C Is Strongly Associated with Abnormal CD4/CD8 Ratio in HIV Patients under Stable ART in Salvador, Brazil.

Brites-Alves C, Netto EM, Brites C - J Immunol Res (2015)

Proportion of patients reaching inadequate, partial, or adequate immune restoration, according to mean CD4 count nadir.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4556079&req=5

fig1: Proportion of patients reaching inadequate, partial, or adequate immune restoration, according to mean CD4 count nadir.
Mentions: Mean follow-up duration was 1804 ± 1189 days. Table 1 displays the main demographic characteristics of groups. We detected a higher proportion of MSM patients presenting with inadequate immune restoration in comparison with subjects infected by heterosexual contact, but it did not reach statistical significance. In addition, women were more likely to achieve AR than men, but they had mean CD4 count nadir significantly higher than that observed for men (264.7 ± 176.6 cells/mm3 versus 209.8 ± 190.5, resp., p < 0.001). Figure 1 displays the distribution of groups across different CD4 strata.

Bottom Line: Male gender (p < 0.01), lower mean CD4 nadir (p < 0.001), higher baseline VL (p = 0.01), previous diagnosis of Tb (p = 0.03), or HCV (p < 0.01) was associated with IR.Longer time under suppressive ART was also associated with a greater chance of AR, but logistic regression identified coinfection by HCV as the main factor associated with abnormal CD4/CD8 ratio.Previous HCV diagnosis significantly increases the risk of abnormal CD4/CD8 ratio.

View Article: PubMed Central - PubMed

Affiliation: Laboratorio de Pesquisas em Infectologia, Complexo Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.

ABSTRACT

Unlabelled: Proper immune restoration (CD4 count >500 and normal CD4/8 ratio) is reached only by a fraction of HIV patients, despite stable viral suppression.

Methods: We present a case-control study to compare HIV patients with viral suppression >1 year, according to immune restoration pattern: adequate response (AR) defined by CD4 > 500 cells/mm(3) and CD4/8 ratio >1; partial response (PR = patients with CD4 > 500, but CD4/8 ratio <1); inadequate response (IR = CD4 < 500 cells).

Results: We evaluated 293 consecutive patients (89 AR, 112 PR, and 92 IR), 70% males. Male gender (p < 0.01), lower mean CD4 nadir (p < 0.001), higher baseline VL (p = 0.01), previous diagnosis of Tb (p = 0.03), or HCV (p < 0.01) was associated with IR. Likelihood of AR/PR was similar regardless of gender, after adjusting for nadir CD4+ cells count. Longer time under suppressive ART was also associated with a greater chance of AR, but logistic regression identified coinfection by HCV as the main factor associated with abnormal CD4/CD8 ratio.

Conclusion: Early initiation of ART and longer time since first undetectable PVL were predictors of AR. Previous HCV diagnosis significantly increases the risk of abnormal CD4/CD8 ratio.

No MeSH data available.


Related in: MedlinePlus