OBJECTIVE: In virologically suppressed HIV-infected adults, noncommunicable diseases (NCDs) have been associated with immune senescence and low CD4/CD8 lymphocyte ratio. Age differences in the relationship between CD4/CD8 ratio and NCDs have not been described. DESIGN: Observational cohort study. METHODS: We assessed CD4/CD8 ratio and incident NCDs (cardiovascular, cancer, liver, and renal diseases) in HIV-infected adults started on antiretroviral therapy between 1998 and 2012. Study inclusion began once patients maintained virologic suppression for 12 months (defined as baseline). We examined age and baseline CD4/CD8 ratio and used Cox proportional hazard models to assess baseline CD4/CD8 ratio and NCDs. RESULTS: This study included 2006 patients. Low baseline CD4/CD8 ratio was associated with older age, male sex, and low CD4 lymphocyte counts. In models adjusting for CD4 lymphocyte count, CD4/CD8 ratio was inversely associated with age (P < 0.01). Among all patients, 182 had incident NCDs, including 46 with coronary artery disease (CAD) events. CD4/CD8 ratio was inversely associated with risk of CAD events [adjusted HR per 0.1 increase in CD4/CD8 ratio = 0.87, 95% confidence interval (CI): 0.76-0.99, P = 0.03]. This association was driven by those under age 50 years (adjusted HR 0.83 [0.70-0.97], P = 0.02) vs. those over age 50 years (adjusted HR = 0.96 [0.79-1.18], P = 0.71). CD4/CD8 ratio was not significantly associated with incident noncardiac NCDs. CONCLUSIONS: Higher CD4/CD8 ratio after 1 year of HIV virologic suppression was independently predictive of decreased CAD risk, particularly among younger adults. Advanced immune senescence may contribute to CAD events in younger HIV patients on antiretroviral therapy.
OBJECTIVE: In virologically suppressed HIV-infected adults, noncommunicable diseases (NCDs) have been associated with immune senescence and low CD4/CD8 lymphocyte ratio. Age differences in the relationship between CD4/CD8 ratio and NCDs have not been described. DESIGN: Observational cohort study. METHODS: We assessed CD4/CD8 ratio and incident NCDs (cardiovascular, cancer, liver, and renal diseases) in HIV-infected adults started on antiretroviral therapy between 1998 and 2012. Study inclusion began once patients maintained virologic suppression for 12 months (defined as baseline). We examined age and baseline CD4/CD8 ratio and used Cox proportional hazard models to assess baseline CD4/CD8 ratio and NCDs. RESULTS: This study included 2006 patients. Low baseline CD4/CD8 ratio was associated with older age, male sex, and low CD4 lymphocyte counts. In models adjusting for CD4 lymphocyte count, CD4/CD8 ratio was inversely associated with age (P < 0.01). Among all patients, 182 had incident NCDs, including 46 with coronary artery disease (CAD) events. CD4/CD8 ratio was inversely associated with risk of CAD events [adjusted HR per 0.1 increase in CD4/CD8 ratio = 0.87, 95% confidence interval (CI): 0.76-0.99, P = 0.03]. This association was driven by those under age 50 years (adjusted HR 0.83 [0.70-0.97], P = 0.02) vs. those over age 50 years (adjusted HR = 0.96 [0.79-1.18], P = 0.71). CD4/CD8 ratio was not significantly associated with incident noncardiac NCDs. CONCLUSIONS: Higher CD4/CD8 ratio after 1 year of HIV virologic suppression was independently predictive of decreased CAD risk, particularly among younger adults. Advanced immune senescence may contribute to CAD events in younger HIVpatients on antiretroviral therapy.
Authors: A Amadori; R Zamarchi; G De Silvestro; G Forza; G Cavatton; G A Danieli; M Clementi; L Chieco-Bianchi Journal: Nat Med Date: 1995-12 Impact factor: 53.440
Authors: Matthew S Freiberg; Chung-Chou H Chang; Lewis H Kuller; Melissa Skanderson; Elliott Lowy; Kevin L Kraemer; Adeel A Butt; Matthew Bidwell Goetz; David Leaf; Kris Ann Oursler; David Rimland; Maria Rodriguez Barradas; Sheldon Brown; Cynthia Gibert; Kathy McGinnis; Kristina Crothers; Jason Sico; Heidi Crane; Alberta Warner; Stephen Gottlieb; John Gottdiener; Russell P Tracy; Matthew Budoff; Courtney Watson; Kaku A Armah; Donna Doebler; Kendall Bryant; Amy C Justice Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873
Authors: Oluwatosin A Badejo; Chung-Chou Chang; Kaku A So-Armah; Russell P Tracy; Jason V Baker; David Rimland; Adeel A Butt; Adam J Gordon; Charles R Rinaldo; Kevin Kraemer; Jeffrey H Samet; Hilary A Tindle; Matthew B Goetz; Maria C Rodriguez-Barradas; Roger Bedimo; Cynthia L Gibert; David A Leaf; Lewis H Kuller; Steven G Deeks; Amy C Justice; Matthew S Freiberg Journal: Biomed Res Int Date: 2015-01-19 Impact factor: 3.411
Authors: Ingjerd W Manner; Marius Trøseid; Olav Oektedalen; Morten Baekken; Ingrid Os Journal: J Clin Hypertens (Greenwich) Date: 2012-10-26 Impact factor: 3.738
Authors: Sergio Serrano-Villar; María Jesús Pérez-Elías; Fernando Dronda; José Luis Casado; Ana Moreno; Ana Royuela; José Antonio Pérez-Molina; Talia Sainz; Enrique Navas; José Manuel Hermida; Carmen Quereda; Santiago Moreno Journal: PLoS One Date: 2014-01-30 Impact factor: 3.240
Authors: Joseph C Mudd; Soumya Panigrahi; Benjamin Kyi; So Hee Moon; Maura M Manion; Souheil-Antoine Younes; Scott F Sieg; Nicholas T Funderburg; David A Zidar; Michael M Lederman; Michael L Freeman Journal: J Infect Dis Date: 2016-10-04 Impact factor: 5.226
Authors: Jessica L Castilho; Megan Turner; Bryan E Shepherd; John R Koethe; Sally S Furukawa; Carmen E Bofill; Stephen Raffanti; Timothy R Sterling Journal: AIDS Res Hum Retroviruses Date: 2019-09-17 Impact factor: 2.205
Authors: I Rosado-Sánchez; I Herrero-Fernández; A I Álvarez-Ríos; M Genebat; M A Abad-Carrillo; E Ruiz-Mateos; F Pulido; J González-García; M Montero; E Bernal-Morell; F Vidal; M Leal; Y M Pacheco Journal: Antimicrob Agents Chemother Date: 2017-07-25 Impact factor: 5.191
Authors: Stephan Emmrich; Alexandre Trapp; Frances Tolibzoda Zakusilo; Maggie E Straight; Albert K Ying; Alexander Tyshkovskiy; Marco Mariotti; Spencer Gray; Zhihui Zhang; Michael G Drage; Masaki Takasugi; Jan-Henning Klusmann; Vadim N Gladyshev; Andrei Seluanov; Vera Gorbunova Journal: EMBO J Date: 2022-06-13 Impact factor: 14.012
Authors: Usman J Wudil; Muktar H Aliyu; Heather L Prigmore; Donna J Ingles; Aima A Ahonkhai; Baba M Musa; Hamza Muhammad; Mahmoud U Sani; Aisha M Nalado; Aliyu Abdu; Kabiru Abdussalam; Bryan E Shepherd; Faisal S Dankishiya; Anna M Burgner; T Alp Ikizler; Christina M Wyatt; Jeffrey B Kopp; Paul L Kimmel; Cheryl A Winkler; C William Wester Journal: Kidney Int Date: 2021-04-24 Impact factor: 18.998