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Clin Infect Dis. 2016 Feb 1;62(3):392-6. doi: 10.1093/cid/civ840. Epub 2015 Sep 23.

CD8 T-Cell Expansion and Inflammation Linked to CMV Coinfection in ART-treated HIV Infection.

Author information

1
Center for AIDS Research, Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University/University Hospitals Case Medical Center.
2
Center for AIDS Research, Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University/University Hospitals Case Medical Center, Veterans Administration Medical Center, Cleveland, Ohio.
3
Department of Medicine, University of California San Francisco.
4
Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation, Ohio.
5
Division of Infectious Diseases, University of California San Diego, La Jolla.

Abstract

BACKGROUND:

Persistent CD8 T-cell expansion, low CD4/CD8 T-cell ratios, and heightened inflammation persist in antiretroviral therapy (ART)-treated human immunodeficiency virus (HIV) infection and are associated with increased risk of morbid outcomes. We explored the role of cytomegalovirus (CMV) infection in CD8 lymphocytosis and inflammation in ART-treated HIV infection.

METHODS:

Absolute CD4 and CD8 T-cell counts were abstracted from clinical records and compared among 32 HIV-infected CMV-seronegative subjects, 126 age, CD4 and gender-matched HIV-infected CMV-seropositive subjects, and among 21 HIV-uninfected controls (9 CMV-negative, 12 CMV-positive). Plasma inflammatory indices were measured in a subset by ELISA.

RESULTS:

Median CD8 counts/µL were higher in HIV-positive/CMV-positive patients (795) than in HIV-positive/CMV-negative subjects (522, P = .006) or in healthy controls (451, P = .0007), whereas CD8 T-cell counts were similar to controls' levels in HIV-positive/CMV-negative subjects. Higher plasma levels of IP-10 (P = .0011), TNF-RII (P = .0002), and D-dimer (P = .0444) were also found in coinfected patients than in HIV-positive/CMV-negative subjects.

CONCLUSIONS:

CMV infection is associated with higher CD8 T-cell counts, resultant lower CD4/CD8 ratios, and increased systemic inflammation in ART-treated HIV infection. CMV infection may contribute to risk for morbid outcomes in treated HIV infection.

KEYWORDS:

CD8 T-cell expansion; CMV; HIV; coinfection; inflammation

PMID:
26400999
PMCID:
PMC4706630
DOI:
10.1093/cid/civ840
[Indexed for MEDLINE]
Free PMC Article

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