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Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study

OBJECTIVES: To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART). METHODS: The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-d...

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Autores principales: Hema, Mariam Noelie, Ferry, Tristan, Dupon, Michel, Cuzin, Lise, Verdon, Renaud, Thiébaut, Rodolphe, Protopopescu, Camelia, Leport, Catherine, Raffi, François, Le Moing, Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993515/
https://www.ncbi.nlm.nih.gov/pubmed/27548257
http://dx.doi.org/10.1371/journal.pone.0161594
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author Hema, Mariam Noelie
Ferry, Tristan
Dupon, Michel
Cuzin, Lise
Verdon, Renaud
Thiébaut, Rodolphe
Protopopescu, Camelia
Leport, Catherine
Raffi, François
Le Moing, Vincent
author_facet Hema, Mariam Noelie
Ferry, Tristan
Dupon, Michel
Cuzin, Lise
Verdon, Renaud
Thiébaut, Rodolphe
Protopopescu, Camelia
Leport, Catherine
Raffi, François
Le Moing, Vincent
author_sort Hema, Mariam Noelie
collection PubMed
description OBJECTIVES: To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART). METHODS: The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm(3), CD4 > 500/mm(3) and CD4/CD8 ratio < 1, CD4 > 500/mm(3) and CD4/CD8 ratio > 1). Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion. RESULTS: We included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2–11.4). Median CD4 was 530/mm(3) at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2–0.5) at baseline and 0.6 (IQR: 0.4–0.9) after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%), cardiovascular events (14%) and cancers (10%). For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32–3.44). CONCLUSIONS: CD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening.
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spelling pubmed-49935152016-09-12 Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study Hema, Mariam Noelie Ferry, Tristan Dupon, Michel Cuzin, Lise Verdon, Renaud Thiébaut, Rodolphe Protopopescu, Camelia Leport, Catherine Raffi, François Le Moing, Vincent PLoS One Research Article OBJECTIVES: To study the association between CD4/CD8 ratio and morbidity in HIV-infected patients on antiretroviral therapy (ART). METHODS: The APROCO/COPILOTE cohort enrolled patients initiating a protease inhibitor-containing ART in 1997–1999. The association between occurrence of first non AIDS-defining severe events (NADE) and time-dependent measures of immune restoration was assessed by 4 Cox models with different definitions of restoration, CD4+ cell counts (CD4), CD4/CD8 ratio, both CD4 and CD4/CD8 ratio, or a composite variable (CD4< 500/mm(3), CD4 > 500/mm(3) and CD4/CD8 ratio < 1, CD4 > 500/mm(3) and CD4/CD8 ratio > 1). Models adjusted on baseline characteristics and time-dependent viral load were compared using Akaike Information Criterion. RESULTS: We included 1227 patients. Median duration of follow-up was 9.2 years (IQR: 4.2–11.4). Median CD4 was 530/mm(3) at 9 years. Median CD4/CD8 ratio was 0.3 (IQR: 0.2–0.5) at baseline and 0.6 (IQR: 0.4–0.9) after 9 years. Incidence of first NADE was 7.4/100 person-years, the most common being bacterial infections (21%), cardiovascular events (14%) and cancers (10%). For both bacterial infections and cardiovascular events, the CD4/CD8 ratio did not add predictive information to the CD4 cell count. However, low CD4/CD8 ratio was the best predictor of non-AIDS cancers (adjusted HR = 2.13 for CD4/CD8 < 0.5; 95% CI = 1.32–3.44). CONCLUSIONS: CD4/CD8 ratio remains < 1 in most HIV-infected patients despite long-term CD4+ cell counts restoration on ART. A CD4/CD8 ratio < 0.5 could identify patients who require a more intensive strategy of cancer prevention or screening. Public Library of Science 2016-08-22 /pmc/articles/PMC4993515/ /pubmed/27548257 http://dx.doi.org/10.1371/journal.pone.0161594 Text en © 2016 Hema et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hema, Mariam Noelie
Ferry, Tristan
Dupon, Michel
Cuzin, Lise
Verdon, Renaud
Thiébaut, Rodolphe
Protopopescu, Camelia
Leport, Catherine
Raffi, François
Le Moing, Vincent
Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title_full Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title_fullStr Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title_full_unstemmed Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title_short Low CD4/CD8 Ratio Is Associated with Non AIDS-Defining Cancers in Patients on Antiretroviral Therapy: ANRS CO8 (Aproco/Copilote) Prospective Cohort Study
title_sort low cd4/cd8 ratio is associated with non aids-defining cancers in patients on antiretroviral therapy: anrs co8 (aproco/copilote) prospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993515/
https://www.ncbi.nlm.nih.gov/pubmed/27548257
http://dx.doi.org/10.1371/journal.pone.0161594
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