Limits...
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

Distribution of patients by immune restoration patterns according to mean nadir CD4 cells and past diagnosis of tuberculosis (a) or HCV infection (b).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4556079&req=5

fig2: Distribution of patients by immune restoration patterns according to mean nadir CD4 cells and past diagnosis of tuberculosis (a) or HCV infection (b).

Mentions: The effect of HCV infection on CD4/CD8 ratio is clearly observed in the PR group: most of HIV-HCV coinfected patients presented with CD4 count higher than 500 cells/mm3 but a CD4/CD8 ratio below 1.0. Figure 2 shows the pattern of immune restoration for patients according to past tuberculosis/HCV coinfection and CD4 nadir range.


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)

Distribution of patients by immune restoration patterns according to mean nadir CD4 cells and past diagnosis of tuberculosis (a) or HCV infection (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Distribution of patients by immune restoration patterns according to mean nadir CD4 cells and past diagnosis of tuberculosis (a) or HCV infection (b).
Mentions: The effect of HCV infection on CD4/CD8 ratio is clearly observed in the PR group: most of HIV-HCV coinfected patients presented with CD4 count higher than 500 cells/mm3 but a CD4/CD8 ratio below 1.0. Figure 2 shows the pattern of immune restoration for patients according to past tuberculosis/HCV coinfection and CD4 nadir range.

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