Enhanced normalisation of CD4/CD8 ratio with earlier antiretroviral therapy at Primary HIV Infection

John Thornhill, Jamie Inshaw, Pontiano Kaleebu, David Cooper, Gita Ramjee, Mauro Schechter, Giuseppe Tambussi, Julie Fox, Miriam Samuel, Jose Maria Miro, Jonathan Weber, Kholoud Porter, Sarah Fidler

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND:: Total CD4 T-cell counts predict HIV disease progression, but do not necessarily reflect normalization of immune function. CD4/CD8 ratio is a marker of immune dysfunction, a prognostic indicator for non-AIDS mortality, and reflects viral reservoir size. Despite ART, recovery of CD4/CD8 ratio in chronic HIV infection is incomplete; we hypothesize enhanced CD4/CD8 ratio recovery with earlier treatment initiation in recently infected individuals. METHODS:: CD4 count and CD4/CD8 ratio were analyzed using data from two cohorts: SPARTAC trial, and the UK HIV Seroconverters Cohort where Primary HIV infection (PHI) was defined as within 6 months from estimated date of infection. Using time-to-event methods and Cox proportional hazard models we examined the effect of CD4/CD8 ratio at seroconversion on disease progression (CD41.0). FINDINGS:: Of 573 seroconverters, 482 (84%) had abnormal CD4/CD8 ratios at HIV seroconversion. Individuals with higher CD4/CD8 ratio at seroconversion were significantly less likely to reach the disease progression end point (aHR [95% CI] = 0.52 [0.32, 0.82], p=0.005). The longer the interval between seroconversion and ART initiation (HR [95% CI] =0.98 per month increase [0.97, 0.99], p

Original languageEnglish
JournalJournal of Acquired Immune Deficiency Syndromes
DOIs
Publication statusAccepted/In press - Apr 6 2016

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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