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CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART

Cytomegalovirus (CMV) infection is common among HIV-infected patients but its repercussion on the course of CD4+ and CD8+ T cells after cART initiation remains elusive. The French Dat'AIDS cohort enrolled 5,688 patients on first-line cART, from which we selected patients who achieved HIV suppre...

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Autores principales: Poizot-Martin, Isabelle, Allavena, Clotilde, Duvivier, Claudine, Cano, Carla Eliana, Guillouet de Salvador, Francine, Rey, David, Dellamonica, Pierre, Cuzin, Lise, Cheret, Antoine, Hoen, Bruno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100980/
https://www.ncbi.nlm.nih.gov/pubmed/27824907
http://dx.doi.org/10.1371/journal.pone.0165774
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author Poizot-Martin, Isabelle
Allavena, Clotilde
Duvivier, Claudine
Cano, Carla Eliana
Guillouet de Salvador, Francine
Rey, David
Dellamonica, Pierre
Cuzin, Lise
Cheret, Antoine
Hoen, Bruno
author_facet Poizot-Martin, Isabelle
Allavena, Clotilde
Duvivier, Claudine
Cano, Carla Eliana
Guillouet de Salvador, Francine
Rey, David
Dellamonica, Pierre
Cuzin, Lise
Cheret, Antoine
Hoen, Bruno
author_sort Poizot-Martin, Isabelle
collection PubMed
description Cytomegalovirus (CMV) infection is common among HIV-infected patients but its repercussion on the course of CD4+ and CD8+ T cells after cART initiation remains elusive. The French Dat'AIDS cohort enrolled 5,688 patients on first-line cART, from which we selected patients who achieved HIV suppression for at least 12 months without modification of cART, and for whom CMV serostatus was available. Five hundred and three patients fulfilled the selection criteria (74% male, median age 43 yrs, 15.5% CDC stage C), of whom 444 (88.3%) were seropositive for CMV (CMV+). Multivariate analyses using mixed-linear models adjusted for the time from HIV suppression, sex, age, transmission risk group, duration of HIV follow-up, the interaction between time from HIV suppression and CMV+ serology, and the nadir CD4 count revealed a negative correlation between CMV+ and CD4:CD8 ratio (coeff. = -0.16; p = 0.001). This correlation was also observed among patients displaying optimal CD4 recovery (≥500 cells/mm3 at M12; coeff. = -0.24; p = 0.002). Hence, CMV+ serostatus antagonizes normalization of the CD4:CD8 ratio, although further analyses of the impact of co-morbidities that associate with CMV serostatus, like HCV infection, are needed to elucidate this antagonism formally. However, this might reflect a premature T cell senescence, thus advocating for a close monitoring of T cells in CMV co-infected patients. In addition, our results raise the question of the benefit of treatment for asymptomatic CMV co-infection in HIV-infected patients.
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spelling pubmed-51009802016-11-18 CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART Poizot-Martin, Isabelle Allavena, Clotilde Duvivier, Claudine Cano, Carla Eliana Guillouet de Salvador, Francine Rey, David Dellamonica, Pierre Cuzin, Lise Cheret, Antoine Hoen, Bruno PLoS One Research Article Cytomegalovirus (CMV) infection is common among HIV-infected patients but its repercussion on the course of CD4+ and CD8+ T cells after cART initiation remains elusive. The French Dat'AIDS cohort enrolled 5,688 patients on first-line cART, from which we selected patients who achieved HIV suppression for at least 12 months without modification of cART, and for whom CMV serostatus was available. Five hundred and three patients fulfilled the selection criteria (74% male, median age 43 yrs, 15.5% CDC stage C), of whom 444 (88.3%) were seropositive for CMV (CMV+). Multivariate analyses using mixed-linear models adjusted for the time from HIV suppression, sex, age, transmission risk group, duration of HIV follow-up, the interaction between time from HIV suppression and CMV+ serology, and the nadir CD4 count revealed a negative correlation between CMV+ and CD4:CD8 ratio (coeff. = -0.16; p = 0.001). This correlation was also observed among patients displaying optimal CD4 recovery (≥500 cells/mm3 at M12; coeff. = -0.24; p = 0.002). Hence, CMV+ serostatus antagonizes normalization of the CD4:CD8 ratio, although further analyses of the impact of co-morbidities that associate with CMV serostatus, like HCV infection, are needed to elucidate this antagonism formally. However, this might reflect a premature T cell senescence, thus advocating for a close monitoring of T cells in CMV co-infected patients. In addition, our results raise the question of the benefit of treatment for asymptomatic CMV co-infection in HIV-infected patients. Public Library of Science 2016-11-08 /pmc/articles/PMC5100980/ /pubmed/27824907 http://dx.doi.org/10.1371/journal.pone.0165774 Text en © 2016 Poizot-Martin 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
Poizot-Martin, Isabelle
Allavena, Clotilde
Duvivier, Claudine
Cano, Carla Eliana
Guillouet de Salvador, Francine
Rey, David
Dellamonica, Pierre
Cuzin, Lise
Cheret, Antoine
Hoen, Bruno
CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title_full CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title_fullStr CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title_full_unstemmed CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title_short CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART
title_sort cmv+ serostatus associates negatively with cd4:cd8 ratio normalization in controlled hiv-infected patients on cart
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100980/
https://www.ncbi.nlm.nih.gov/pubmed/27824907
http://dx.doi.org/10.1371/journal.pone.0165774
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