Role of Normalized T-Cell Subsets in Predicting Comorbidities in a Large Cohort of Geriatric HIV-infected Patient

GEPPO (GEriatric Patients living with HIV/AIDS: a Prospective Multidimensional cOhort) Study Group

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Adults aging with HIV are at greater risk for several comorbidities. The CD4+ cell count and CD4+/CD8+ ratio often fail to normalize in elderly patients despite prolonged antiretroviral therapy; this has been associated with concomitant diseases and poor prognosis. METHODS:: A cross-sectional analysis in antiretroviral-treated HIV-positive patients aged ≥65 years. Aim of the study was to describe the predictors of normalized T cell subsets (“nT”, CD4+/CD8+ ratio ≥1 and CD4+ ≥500 cells/uL) in a cohort of geriatric HIV-positive patients and its association with HIV-associated non-AIDS conditions (HANA). RESULTS:: 1092 patients were included: nT was observed in 340 patients (31.1%). Multivariate binary logistic analysis showed that plasma HIV RNA <50 copies/mL (p=0.004), female gender (p=0.002) and nadir CD4+ cell count (p <0.001) were independent predictors of nT. Age and gender-adjusted prevalence of hypertension (p=0.037), lipid abnormalities (p=0.040) and multimorbidity (MM, p=0.034) was higher in subjects with nT while chronic obstructive pulmonary disease (COPD) and cancer were lower (respectively p=0.028 and p=0.005). Multivariate analysis showed that HIV duration was an independent predictor of several comorbidities while nT was protective for cancer and COPD. HIV duration and nT were simultaneously predictors of MM. CONCLUSIONS:: Normalized T cell subsets were observed in approximately one third of geriatric HIV-positive subjects and they were predicted by female gender and immunovirological features. HANA conditions were more prevalent in patients with longer HIV duration while nT represented a protective factor for cancer and COPD. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Original languageEnglish
Pages (from-to)338-342
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume76
Issue number3
DOIs
Publication statusPublished - 2017

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