PMID- 28903507
DCOM- 20180223
LR  - 20180504
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 65
IP  - 6
DP  - 2017 Sep 15
TI  - CD4:CD8 Ratio and CD8 Count as Prognostic Markers for Mortality in Human
      Immunodeficiency Virus-Infected Patients on Antiretroviral Therapy: The
      Antiretroviral Therapy Cohort Collaboration (ART-CC).
PG  - 959-966
LID - 10.1093/cid/cix466 [doi]
AB  - Background: We investigated whether CD4:CD8 ratio and CD8 count were prognostic
      for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients 
      with high CD4 count. Methods: We used data from 13 European and North American
      cohorts of human immunodeficiency virus-infected, antiretroviral therapy
      (ART)-naive adults who started ART during 1996-2010, who were followed from the
      date they had CD4 count >/=350 cells/muL and were virologically suppressed
      (baseline). We used stratified Cox models to estimate unadjusted and adjusted
      (for sex, people who inject drugs, ART initiation year, and baseline age, CD4
      count, AIDS, duration of ART) all-cause and cause-specific mortality hazard
      ratios for tertiles of CD4:CD8 ratio (0-0.40, 0.41-0.64 [reference], >0.64) and
      CD8 count (0-760, 761-1138 [reference], >1138 cells/muL) and examined the shape
      of associations using cubic splines. Results: During 276526 person-years, 1834 of
      49865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509
      unknown/unclassifiable deaths). There was little evidence that CD4:CD8 ratio was 
      prognostic for all-cause mortality after adjustment for other factors: the
      adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95% confidence 
      interval [CI], 1.00-1.25). The association of CD8 count with all-cause mortality 
      was U-shaped: aHR for higher vs middle tertile was 1.13 (95% CI, 1.01-1.26).
      AIDS-related mortality declined with increasing CD4:CD8 ratio and decreasing CD8 
      count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic
      for non-AIDS mortality. Conclusions: In this large cohort collaboration, the
      magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality
      was too small for them to be useful as independent prognostic markers in virally 
      suppressed patients on ART.
CI  - (c) The Author 2017. Published by Oxford University Press for the Infectious
      Diseases Society of America.
FAU - Trickey, Adam
AU  - Trickey A
AD  - School of Social and Community Medicine, University of Bristol, United Kingdom.
FAU - May, Margaret T
AU  - May MT
AD  - School of Social and Community Medicine, University of Bristol, United Kingdom.
FAU - Schommers, Philipp
AU  - Schommers P
AD  - Department I for Internal Medicine, University Hospital of Cologne, Germany.
FAU - Tate, Jan
AU  - Tate J
AD  - Yale University School of Medicine, West Haven, Connecticut.
FAU - Ingle, Suzanne M
AU  - Ingle SM
AD  - School of Social and Community Medicine, University of Bristol, United Kingdom.
FAU - Guest, Jodie L
AU  - Guest JL
AD  - HIV Atlanta Veterans Affairs Cohort Study, Atlanta Veterans Affairs Medical
      Center, Decatur, Georgia.
FAU - Gill, M John
AU  - Gill MJ
AD  - Division of Infectious Diseases, University of Calgary, Alberta, Canada.
FAU - Zangerle, Robert
AU  - Zangerle R
AD  - Innsbruck Medical University, Austria.
FAU - Saag, Mike
AU  - Saag M
AD  - Division of Infectious Disease, Department of Medicine, University of Alabama,
FAU - Reiss, Peter
AU  - Reiss P
AD  - Stichting HIV Monitoring, and Division of Infectious Diseases and Department of
      Global Health, Academic Medical Center, University of Amsterdam, and Amsterdam
      Institute for Global Health and Development, The Netherlands.
FAU - Monforte, Antonella d'Arminio
AU  - Monforte AD
AD  - Clinic of Infectious Diseases and Tropical Medicine, San Paolo Hospital,
      University of Milan, Italy.
FAU - Johnson, Margaret
AU  - Johnson M
AD  - Department of HIV Medicine, Royal Free London NHS Foundation Trust, United
FAU - Lima, Viviane D
AU  - Lima VD
AD  - British Columbia Centre for Excellence in HIV/AIDS, and Division of AIDS, Faculty
      of Medicine, University of British Columbia, Vancouver, Canada.
FAU - Sterling, Tim R
AU  - Sterling TR
AD  - Vanderbilt University School of Medicine, Nashville, Tennessee.
FAU - Cavassini, Matthias
AU  - Cavassini M
AD  - Service of Infectious Diseases, Lausanne University Hospital and University of
      Lausanne, Switzerland.
FAU - Wittkop, Linda
AU  - Wittkop L
AD  - INSERM, Unit of Epidemiology and Biostatistics, Bordeaux.
FAU - Costagliola, Dominique
AU  - Costagliola D
AD  - Sorbonne Universites, INSERM, UPMC Universite Paris 06, Institut Pierre Louis
      d'epidemiologie et de Sante Publique (IPLESP UMRS 1136), Paris, France.
FAU - Sterne, Jonathan A C
AU  - Sterne JAC
AD  - School of Social and Community Medicine, University of Bristol, United Kingdom.
CN  - Antiretroviral Therapy Cohort Collaboration (ART-CC)
LA  - eng
GR  - G0100221/Medical Research Council/United Kingdom
GR  - G0700820/Medical Research Council/United Kingdom
GR  - MR/J002380/1/Medical Research Council/United Kingdom
PT  - Journal Article
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases
      Society of America
JID - 9203213
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Biomarkers)
SB  - IM
CIN - J Lab Precis Med. 2018 Feb;3:. PMID: 30167571
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Anti-HIV Agents/therapeutic use
MH  - Biomarkers/blood
MH  - *CD4-CD8 Ratio
MH  - *CD4-Positive T-Lymphocytes
MH  - *CD8-Positive T-Lymphocytes
MH  - Cause of Death
MH  - Europe/epidemiology
MH  - Female
MH  - HIV Infections/drug therapy/*immunology/*mortality
MH  - Humans
MH  - Lymphocyte Count
MH  - Male
MH  - Middle Aged
MH  - North America/epidemiology
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Viral Load
MH  - Young Adult
PMC - PMC5850630
OT  - CD4:CD8 ratio
OT  - CD8 count
OT  - antiretroviral therapy
OT  - mortality
IR  - Boulle A
FIR - Boulle, Andrew
IR  - Stephan C
FIR - Stephan, Christoph
IR  - Miro JM
FIR - Miro, Jose M
IR  - Cavassini M
FIR - Cavassini, Matthias
IR  - Chene G
FIR - Chene, Genevieve
IR  - Costagliola D
FIR - Costagliola, Dominique
IR  - Dabis F
FIR - Dabis, Francois
IR  - Monforte AD
FIR - Monforte, Antonella D'Arminio
IR  - Del Amo J
FIR - Del Amo, Julia
IR  - Van Sighem A
FIR - Van Sighem, Ard
IR  - Vehreschild JJ
FIR - Vehreschild, Jorg Janne
IR  - Gill J
FIR - Gill, John
IR  - Guest J
FIR - Guest, Jodie
IR  - Haerry DH
FIR - Haerry, David Hans-Ulrich
IR  - Hogg R
FIR - Hogg, Robert
IR  - Justice A
FIR - Justice, Amy
IR  - Shepherd L
FIR - Shepherd, Leah
IR  - Obel N
FIR - Obel, Niels
IR  - Crane HM
FIR - Crane, Heidi M
IR  - Smith C
FIR - Smith, Colette
IR  - Reiss P
FIR - Reiss, Peter
IR  - Saag M
FIR - Saag, Michael
IR  - Sterling T
FIR - Sterling, Tim
IR  - Teira R
FIR - Teira, Ramon
IR  - Williams M
FIR - Williams, Matthew
IR  - Zangerle R
FIR - Zangerle, Robert
IR  - Sterne J
FIR - Sterne, Jonathan
IR  - May M
FIR - May, Margaret
IR  - Ingle S
FIR - Ingle, Suzanne
IR  - Trickey A
FIR - Trickey, Adam
EDAT- 2017/09/15 06:00
MHDA- 2018/02/24 06:00
CRDT- 2017/09/15 06:00
PHST- 2017/02/06 00:00 [received]
PHST- 2017/05/22 00:00 [accepted]
PHST- 2017/09/15 06:00 [entrez]
PHST- 2017/09/15 06:00 [pubmed]
PHST- 2018/02/24 06:00 [medline]
AID - 3952683 [pii]
AID - 10.1093/cid/cix466 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2017 Sep 15;65(6):959-966. doi: 10.1093/cid/cix466.