Articles producció científica> Medicina i Cirurgia

Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events

  • Datos identificativos

    Identificador: imarina:9333674
    Autores:
    Martínez-Sanz, JDiaz-alvarez, JRosas, MRon, RIribarren, JABernal, EGutiérrez, FSancho, ARCabello, NOlalla, JMoreno, SSerrano-Villar, S
    Resumen:
    Background While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear.Methods We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events.Findings The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio <0.3 predicted an increased risk of SNAEs during the next five years (OR 1.63, 95% CI 1.03-2.58). The effect was stronger at a CD4/CD8 ratio cut-off of <0.2 (OR 3.09, 95% CI 1.57-6.07). Additionally, low CD4 count at cut-offs of <500 cells/mu L predicted an increased risk of clinical events. Among participants with a CD4 count >500 cells/mu L, a CD8 count >1500 cells/mu L or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.Interpretation Our results support the use of the CD4/CD8 ratio and CD8 count as predictors of clinical progression. Patients with CD4/CD8 ratio <0.3 or CD8 count >1500/mu L, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.Copyright (c) 2023 The Author(s). Published by Elsevier B.V.
  • Otros:

    Autor según el artículo: Martínez-Sanz, J; Diaz-alvarez, J; Rosas, M; Ron, R; Iribarren, JA; Bernal, E; Gutiérrez, F; Sancho, AR; Cabello, N; Olalla, J; Moreno, S; Serrano-Villar, S
    Departamento: Medicina i Cirurgia
    Autor/es de la URV: Peraire Forner, José Joaquin
    Palabras clave: Risk Population Old Non-aids events Neoplasia Initiation Infected adults Individuals Hiv Hazards Cohort Cell counts Cd4/cd8 ratio Cardiovascular event Antiretroviral therapy
    Resumen: Background While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear.Methods We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events.Findings The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio <0.3 predicted an increased risk of SNAEs during the next five years (OR 1.63, 95% CI 1.03-2.58). The effect was stronger at a CD4/CD8 ratio cut-off of <0.2 (OR 3.09, 95% CI 1.57-6.07). Additionally, low CD4 count at cut-offs of <500 cells/mu L predicted an increased risk of clinical events. Among participants with a CD4 count >500 cells/mu L, a CD8 count >1500 cells/mu L or a CD4/CD8 ratio <0.4 predicted increased SNAE risk.Interpretation Our results support the use of the CD4/CD8 ratio and CD8 count as predictors of clinical progression. Patients with CD4/CD8 ratio <0.3 or CD8 count >1500/mu L, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions.Copyright (c) 2023 The Author(s). Published by Elsevier B.V.
    Áreas temáticas: Saúde coletiva Medicine, research & experimental Medicine (miscellaneous) Medicine (all) Medicina iii Medicina ii Medicina i General medicine General biochemistry,genetics and molecular biology Ciências biológicas ii Biotecnología Biochemistry, genetics and molecular biology (miscellaneous) Biochemistry, genetics and molecular biology (all)
    Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
    Direcció de correo del autor: joaquim.peraire@urv.cat
    Identificador del autor: 0000-0001-7808-5479
    Fecha de alta del registro: 2024-08-03
    Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
    Enlace a la fuente original: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(23)00339-0/fulltext#%20
    URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referencia al articulo segun fuente origial: Ebiomedicine. 95
    Referencia de l'ítem segons les normes APA: Martínez-Sanz, J; Diaz-alvarez, J; Rosas, M; Ron, R; Iribarren, JA; Bernal, E; Gutiérrez, F; Sancho, AR; Cabello, N; Olalla, J; Moreno, S; Serrano-Vil (2023). Expanding HIV clinical monitoring: the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events. Ebiomedicine, 95(), -. DOI: 10.1016/j.ebiom.2023.104773
    DOI del artículo: 10.1016/j.ebiom.2023.104773
    Entidad: Universitat Rovira i Virgili
    Año de publicación de la revista: 2023
    Tipo de publicación: Journal Publications
  • Palabras clave:

    Biochemistry, Genetics and Molecular Biology (Miscellaneous),Medicine (Miscellaneous),Medicine, Research & Experimental
    Risk
    Population
    Old
    Non-aids events
    Neoplasia
    Initiation
    Infected adults
    Individuals
    Hiv
    Hazards
    Cohort
    Cell counts
    Cd4/cd8 ratio
    Cardiovascular event
    Antiretroviral therapy
    Saúde coletiva
    Medicine, research & experimental
    Medicine (miscellaneous)
    Medicine (all)
    Medicina iii
    Medicina ii
    Medicina i
    General medicine
    General biochemistry,genetics and molecular biology
    Ciências biológicas ii
    Biotecnología
    Biochemistry, genetics and molecular biology (miscellaneous)
    Biochemistry, genetics and molecular biology (all)
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