A Lower Baseline CD4/CD8 T-Cell Ratio Is Independently Associated with Immunodiscordant Response to Antiretroviral Therapy in HIV-Infected Subjects

Antimicrob Agents Chemother. 2017 Jul 25;61(8):e00605-17. doi: 10.1128/AAC.00605-17. Print 2017 Aug.

Abstract

We explored if baseline CD4/CD8 T-cell ratio is associated with immunodiscordant response to antiretroviral therapy in HIV-infected subjects. Comparing immunodiscordant and immunoconcordant subjects matched by pretreatment CD4 counts, we observed a lower pretreatment CD4/CD8 T-cell ratio in immunodiscordant subjects. Furthermore, pretreatment CD4/CD8 T-cell ratio, but not CD4 counts, correlated with the main immunological alterations observed in immunodiscordants, including increased regulatory T-cell (Treg) frequency and T-cell turnover-related markers. Then, in a larger cohort, only baseline CD4/CD8 T-cell ratio was independently associated with immunodiscordance, after adjusting by the viral CXCR4-tropic HIV variants. Our results suggest that the CD4/CD8 T-cell ratio could be an accurate biomarker of the subjacent immunological damage triggering immunodiscordance.

Keywords: CD4/CD8 T-cell ratio; CD4/CD8 ratio; T-cell turnover; antiretroviral therapy; delayed cART; human immunodeficiency virus; immunodiscordant; low CD4 recovery; thymic function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods*
  • Biomarkers / metabolism
  • CD4-CD8 Ratio*
  • CD8-Positive T-Lymphocytes / immunology*
  • Cell Survival / drug effects
  • Didanosine / therapeutic use
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology*
  • Humans
  • Male
  • Middle Aged
  • Receptors, CXCR4 / immunology
  • Stavudine / therapeutic use
  • T-Lymphocytes, Regulatory / immunology*
  • Viral Load
  • Zalcitabine / therapeutic use
  • Zidovudine / therapeutic use

Substances

  • Anti-HIV Agents
  • Biomarkers
  • CXCR4 protein, human
  • Receptors, CXCR4
  • Zidovudine
  • Zalcitabine
  • Stavudine
  • Didanosine