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The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment
INTRODUCTION: Inversion of the CD4:CD8 ratio (<1) has been identified as a hallmark of immunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and intima-media thickness (IMT) progression in treated HIV-inf...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International AIDS Society
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225384/ https://www.ncbi.nlm.nih.gov/pubmed/25397469 http://dx.doi.org/10.7448/IAS.17.4.19723 |
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author | Bernal, Enrique Serrano, Jose Perez, Ana Valero, Salvador Garcia, Eva Marín, Irene Muñoz, Angeles Miguel Gomez Verdú, Jose Vera, Carmen Cano, Alfredo |
author_facet | Bernal, Enrique Serrano, Jose Perez, Ana Valero, Salvador Garcia, Eva Marín, Irene Muñoz, Angeles Miguel Gomez Verdú, Jose Vera, Carmen Cano, Alfredo |
author_sort | Bernal, Enrique |
collection | PubMed |
description | INTRODUCTION: Inversion of the CD4:CD8 ratio (<1) has been identified as a hallmark of immunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and intima-media thickness (IMT) progression in treated HIV-infected patients as a marker of early atherosclerosis. MATERIALS AND METHODS: A longitudinal study during three years was conducted in 120 HIV-infected patients receiving antiretroviral treatment (ART). We analyzed the associations between the CD4:CD8 ratio, cardiovascular risk factor and antiretroviral (ARV) treatment and progression of subclinical atherosclerosis assessed using carotid IMT at baseline and after three years. RESULTS: Finally, 96 patients completed the study. Seventy-six (79.1%) patients were male, aged 44±10 years, 39 (40.6%) were on treatment with Protease inhibitors, 49 (51.04%) with non-nucleoside reverse transcriptase inhibitors (NNRTI), 6 (6.25%) with integrase inhibitors, 3 (3.12%) with maraviroc and 2 (2.08%) only with nucleoside reverse transcriptase inhibitors (NRTI). The mean of ARV exposition was 6.9±5.9 years. Twenty six (27 %) patients had family history of ischemic heart disease, 51 (53.12%) were smokers, 12 (12.5%) hypertensive, 4 (4.16%) type 2 diabetes, 23 (23.9%) with dyslipidemia and 31 (32.3%) were infected with C hepatitis virus. Baseline IMT was significantly associated with age (rho=0.497; p<0.001), basal glucemia (rho=0.323; p=0.001), triglycerides (rho=0.232; p=0.023), Framingham score (rho=0.324; p=0.001), CD4:CD8 ratio (rho=−0.176; p=0.05) and dyslipidemia (0.72±0.16 mm vs 0.63±0.11 mm; p=0.029). In multivariable analysis where cardiovascular risk factor and ARV were included, IMT progression was inversely associated with CD4:CD8 ratio (OR=0.283; CI 95% 0.099–0.809; p=0.019) and treatment with NNRTI (OR=0.283; CI 95% 0.099–0.809; p=0.019). CONCLUSIONS: The inversion of CD4:CD8 ratio in treated HIV-infected patients is independently associated with IMT progression, a marker of age-associated disease. Therefore, it might be clinically useful as predictor of cardiovascular events. Surprisingly, there was a positive correlation between receiving NNRTI and progression of IMT. |
format | Online Article Text |
id | pubmed-4225384 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | International AIDS Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-42253842014-11-13 The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment Bernal, Enrique Serrano, Jose Perez, Ana Valero, Salvador Garcia, Eva Marín, Irene Muñoz, Angeles Miguel Gomez Verdú, Jose Vera, Carmen Cano, Alfredo J Int AIDS Soc Poster Sessions – Abstract P191 INTRODUCTION: Inversion of the CD4:CD8 ratio (<1) has been identified as a hallmark of immunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and intima-media thickness (IMT) progression in treated HIV-infected patients as a marker of early atherosclerosis. MATERIALS AND METHODS: A longitudinal study during three years was conducted in 120 HIV-infected patients receiving antiretroviral treatment (ART). We analyzed the associations between the CD4:CD8 ratio, cardiovascular risk factor and antiretroviral (ARV) treatment and progression of subclinical atherosclerosis assessed using carotid IMT at baseline and after three years. RESULTS: Finally, 96 patients completed the study. Seventy-six (79.1%) patients were male, aged 44±10 years, 39 (40.6%) were on treatment with Protease inhibitors, 49 (51.04%) with non-nucleoside reverse transcriptase inhibitors (NNRTI), 6 (6.25%) with integrase inhibitors, 3 (3.12%) with maraviroc and 2 (2.08%) only with nucleoside reverse transcriptase inhibitors (NRTI). The mean of ARV exposition was 6.9±5.9 years. Twenty six (27 %) patients had family history of ischemic heart disease, 51 (53.12%) were smokers, 12 (12.5%) hypertensive, 4 (4.16%) type 2 diabetes, 23 (23.9%) with dyslipidemia and 31 (32.3%) were infected with C hepatitis virus. Baseline IMT was significantly associated with age (rho=0.497; p<0.001), basal glucemia (rho=0.323; p=0.001), triglycerides (rho=0.232; p=0.023), Framingham score (rho=0.324; p=0.001), CD4:CD8 ratio (rho=−0.176; p=0.05) and dyslipidemia (0.72±0.16 mm vs 0.63±0.11 mm; p=0.029). In multivariable analysis where cardiovascular risk factor and ARV were included, IMT progression was inversely associated with CD4:CD8 ratio (OR=0.283; CI 95% 0.099–0.809; p=0.019) and treatment with NNRTI (OR=0.283; CI 95% 0.099–0.809; p=0.019). CONCLUSIONS: The inversion of CD4:CD8 ratio in treated HIV-infected patients is independently associated with IMT progression, a marker of age-associated disease. Therefore, it might be clinically useful as predictor of cardiovascular events. Surprisingly, there was a positive correlation between receiving NNRTI and progression of IMT. International AIDS Society 2014-11-02 /pmc/articles/PMC4225384/ /pubmed/25397469 http://dx.doi.org/10.7448/IAS.17.4.19723 Text en © 2014 Bernal E et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster Sessions – Abstract P191 Bernal, Enrique Serrano, Jose Perez, Ana Valero, Salvador Garcia, Eva Marín, Irene Muñoz, Angeles Miguel Gomez Verdú, Jose Vera, Carmen Cano, Alfredo The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title |
The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title_full |
The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title_fullStr |
The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title_full_unstemmed |
The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title_short |
The CD4:CD8 ratio is associated with IMT progression in HIV-infected patients on antiretroviral treatment |
title_sort | cd4:cd8 ratio is associated with imt progression in hiv-infected patients on antiretroviral treatment |
topic | Poster Sessions – Abstract P191 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225384/ https://www.ncbi.nlm.nih.gov/pubmed/25397469 http://dx.doi.org/10.7448/IAS.17.4.19723 |
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