Human Immunodeficiency Virus (HIV)-Negative Men Who Have Sex With Men Have Higher CD8(+) T-Cell Counts and Lower CD4(+)/CD8(+) T-Cell Ratios Compared With HIV-Negative Heterosexual Men

BACKGROUND: We previously reported T-cell senescence to be similar in people with human immunodeficiency virus (PWH) with suppressed viremia (predominantly men who have sex with men [MSM]) and human immunodeficiency virus (HIV)-negative otherwise comparable controls but greater than in healthy blood donors. This led us to compare CD4(+) and CD8(+) T-cell counts and CD4(+)/CD8(+) ratios between HIV-negative MSM and men who only have sex with women (MSW) and relate observed differences in behavioral factors and infectious exposures, including cytomegalovirus (CMV) infection. METHODS: In 368 HIV-negative MSM and 72 HIV-negative MSW, T lymphocyte phenotyping was performed 3 times biennially. Baseline CMV serology and sexually transmitted infection (STI) incidence and/or STI seroprevalence, sexual, and substance-use behavior data were collected during study visits. RESULTS: Men who have sex with men, compared with MSW, had higher CD8(+) counts (551 vs 437 cells/mm(3), P < .001), similar CD4(+) counts (864 vs 880 cells/mm(3), P = .5), and lower CD4(+)/CD8(+) ratios (1.84 vs 2.47, P < .001). Differences were most pronounced for MSM with >10 recent sex partners and partly explained by higher CMV seroprevalence in MSM. CONCLUSIONS: These findings suggest that factors other than HIV may, in both PWH and certain HIV-negative MSM, contribute to a low CD4(+)/CD8(+) ratio. Whether this, like in PWH, contributes to comorbidity risk in HIV-negative MSM requires further study.