Published 2015
| Version v1
Publication
CD4/CD8 ratio normalisation and non-AIDS-related events in individuals with HIV who achieve viral load suppression with antiretroviral therapy: An observational cohort study
Creators
- Mussini C.
- Lorenzini P.
- Cozzi-Lepri A.
- Lapadula G.
- Marchetti G.
- Nicastri E.
- Cingolani A.
- Lichtner M.
- Antinori A.
- Gori A.
- Monforte A. D.
- Moroni M.
- Andreoni M.
- Angarano G.
- d'Arminio Monforte A.
- Castelli F.
- Cauda R
- Di Perri G.
- Galli M.
- Iardino R
- Ippolito G.
- Lazzarin A.
- Perno C. F.
- von Schloesser F.
- Viale P.
- Castagna A.
- Ceccherini-Silberstein F.
- Girardi E.
- Lo Caputo S.
- Puoti M.
- Ammassari A.
- Balotta C.
- Bonfanti P.
- Bonora S.
- Borderi M.
- Capobianchi M. R.
- Cinque P.
- De Luca A.
- Di Biagio A.
- Gianotti N.
- Guaraldi G.
- Madeddu G.
- Maggiolo F.
- Marcotullio S.
- Monno L.
- Quiros Roldan E.
- Rusconi S.
- Saracino A.
- Cicconi P.
- Fanti Galli I.
- Tavelli A.
- Giacometti A.
- Costantini A.
- Mazzoccato S.
- Suardi C.
- Vanino E.
- Verucchi G.
- Minardi C.
- Quirino T.
- Abeli C.
- E Manconi P.
- Piano P.
- Vecchiet J.
- Falasca K.
- Sighinolfi L.
- Segala D.
- Mazzotta F.
- Cassola G.
- Viscoli C.
- Alessandrini A.
- Piscopo R.
- Mazzarello G.
- Mastroianni C.
- Belvisi V.
- Caramma I.
- Chiodera A.
- Castelli A. P.
- Rizzardini G.
- Ridolfo A. L.
- Piolin R.
- Salpietro S.
- Carenzi L.
- Moioli M. C.
- Tincati C.
- Puzzolante C.
- Abrescia N.
- Chirianni A.
- Guida M. G.
- Gargiulo M.
- Baldelli F.
- Francisci D.
- Parruti G.
- Ursini T.
- Magnani G.
- Ursitti M. A.
- Vullo V
- d'Avino A.
- Gallo L.
- Acinapura R.
- Capozzi M.
- Libertone R.
- Tebano G.
- Cattelan A.
- Sasset L.
- Mura M. S.
- Rossetti B.
- Caramello P.
- Orofino G. C.
- Sciandra M.
- Bassetti M.
- Londero A.
- Pellizzer G.
- Manfrin V.
Contributors
Others:
- Mussini, C.
- Lorenzini, P.
- Cozzi-Lepri, A.
- Lapadula, G.
- Marchetti, G.
- Nicastri, E.
- Cingolani, A.
- Lichtner, M.
- Antinori, A.
- Gori, A.
- Monforte, A. D.
- Moroni, M.
- Andreoni, M.
- Angarano, G.
- d'Arminio Monforte, A.
- Castelli, F.
- Cauda, R
- Di Perri, G.
- Galli, M.
- Iardino, R
- Ippolito, G.
- Lazzarin, A.
- Perno, C. F.
- von Schloesser, F.
- Viale, P.
- Castagna, A.
- Ceccherini-Silberstein, F.
- Girardi, E.
- Lo Caputo, S.
- Puoti, M.
- Ammassari, A.
- Balotta, C.
- Bonfanti, P.
- Bonora, S.
- Borderi, M.
- Capobianchi, M. R.
- Cinque, P.
- De Luca, A.
- Di Biagio, A.
- Gianotti, N.
- Guaraldi, G.
- Madeddu, G.
- Maggiolo, F.
- Marcotullio, S.
- Monno, L.
- Quiros Roldan, E.
- Rusconi, S.
- Saracino, A.
- Cicconi, P.
- Fanti Galli, I.
- Tavelli, A.
- Giacometti, A.
- Costantini, A.
- Mazzoccato, S.
- Suardi, C.
- Vanino, E.
- Verucchi, G.
- Minardi, C.
- Quirino, T.
- Abeli, C.
- E Manconi, P.
- Piano, P.
- Vecchiet, J.
- Falasca, K.
- Sighinolfi, L.
- Segala, D.
- Mazzotta, F.
- Cassola, G.
- Viscoli, C.
- Alessandrini, A.
- Piscopo, R.
- Mazzarello, G.
- Mastroianni, C.
- Belvisi, V.
- Caramma, I.
- Chiodera, A.
- Castelli, A. P.
- Rizzardini, G.
- Ridolfo, A. L.
- Piolin, R.
- Salpietro, S.
- Carenzi, L.
- Moioli, M. C.
- Tincati, C.
- Puzzolante, C.
- Abrescia, N.
- Chirianni, A.
- Guida, M. G.
- Gargiulo, M.
- Baldelli, F.
- Francisci, D.
- Parruti, G.
- Ursini, T.
- Magnani, G.
- Ursitti, M. A.
- Vullo, V
- D'Avino, A.
- Gallo, L.
- Acinapura, R.
- Capozzi, M.
- Libertone, R.
- Tebano, G.
- Cattelan, A.
- Sasset, L.
- Mura, M. S.
- Rossetti, B.
- Caramello, P.
- Orofino, G. C.
- Sciandra, M.
- Bassetti, M.
- Londero, A.
- Pellizzer, G.
- Manfrin, V.
Description
Background: In patients with HIV, immune reconstitution after antiretroviral therapy (ART) is often incomplete. We assessed the probability of patients reaching a CD4/CD8 ratio of 1 or more after the start of ART and its association with the onset of non-AIDS-defining events and death. Methods: We did an analysis of the ICONA cohort, which recruited treatment-naive patients with HIV in Italy. We included participants in the cohort who started ART, reached an undetectable viral load (≤80 copies per mL), and had a CD4/CD8 ratio of less than 0·8 at the time of an undetectable viral load. We defined ratio normalisation in patients as two consecutive values of 1 or more. We used Kaplan-Meier curves to estimate the cumulative probability of ratio normalisation. We then used Poisson regression models to identify factors independently associated with normalisation and with progression to non-AIDS-defining events or death. Findings: We included 3236 participants, enrolled between Jan 22, 1997, and Feb 25, 2013. At the start of ART, median CD4/CD8 ratio in our population was 0·39 (IQR 0·26-0·55). 458 (14%) patients reached a CD4/CD8 ratio of 1 or more; the estimated probability of normalisation was 4·4% (95% CI 3·7-5·2) by 1 year from baseline, 11·5% (10·2-13·0) by 2 years, and 29·4% (26·7-32·4) by 5 years. Factors associated with normalisation were high pre-ART CD4 cell counts, a high CD4/CD8 ratio at baseline, and negative cytomegalovirus serological findings. The incidence rate of non-AIDS-defining events for patients with a CD4/CD8 ratio of less than 0·30 (4·2 per 100 patient-years, 95% CI 3·4-5·3) was double that for those with a ratio of 0·30-0·45 (2·3, 2·1-2·5) or more than 0·45 (2·2, 1·7-2·9). A ratio of less than 0·30 was independently associated with an increased risk of non-AIDS-defining events or death compared with one of more than 0·45. Interpretation: Few patients had normalised CD4/CD8 ratios, even though they had viral suppression. Low ratios were associated with increased risk of serious events and deaths. The CD4/CD8 ratio could be used by clinicians to identity patients at risk of non-AIDS-related events. Funding: AbbVie, Bristol-Myers Squibb, Gilead, Janssen, Merck Sharp & Dohme, ViiV Italy.
Additional details
Identifiers
- URL
- http://hdl.handle.net/11567/875146
- URN
- urn:oai:iris.unige.it:11567/875146
Origin repository
- Origin repository
- UNIGE