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Multicenter Study
. 2016 Jun 1;72(2):162-70.
doi: 10.1097/QAI.0000000000000928.

Association of Hepatitis C Virus Infection With CD4/CD8 Ratio in HIV-Positive Women

Mark H Kuniholm  1 , Thomas R OʼBrien, Ludmila Prokunina-Olsson, Michael Augenbraun, Michael Plankey, Roksana Karim, Monika Sarkar, Audrey L French, Chris Pierce, Howard D Strickler, Kathryn Anastos
Affiliations
Multicenter Study

Association of Hepatitis C Virus Infection With CD4/CD8 Ratio in HIV-Positive Women

Mark H Kuniholm et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Recent studies reported that the CD4/CD8 T-cell ratio is inversely associated with biomarkers traditionally used to measure immune activation and systemic inflammation in highly active antiretroviral therapy-treated HIV-infected (HIV+) patients. The relation of hepatitis C virus (HCV) coinfection with the CD4/CD8 ratio in HIV+ patients is unknown.

Methods: We examined 50,201 CD4/CD8 ratios measured over 20 years in 3 groups of HIV+ women enrolled in the Women's Interagency HIV Study: HCV antibody negative (n = 1734), cleared HCV (n = 231), and chronic HCV (n = 751) in multivariate models. IFNL4-ΔG genotype and HCV viral load were also considered.

Results: Compared with HCV antibody negative status, chronic HCV infection was associated with lower CD4/CD8 ratios when HIV viral load was suppressed to the lower limit of quantification (β = -0.08; P = 0.002). Cleared HCV (β = -0.10; P = 0.0009), but not IFNL4-ΔG genotype or HCV viral load, was also associated with lower CD4/CD8 ratios when HIV viral load was suppressed to the lower limit of quantification.

Conclusions: The association of HCV coinfection with CD4/CD8 ratio is consistent with previously observed associations of HCV coinfection with biomarkers traditionally used to measure immune activation and systemic inflammation in HIV+ patients. These data provide additional support for the use of CD4/CD8 ratio for routine monitoring of immune activation and inflammation in HIV+ patients, including those with HIV/HCV coinfection; however, the unexpected association between cleared HCV and lower CD4/CD8 ratio requires additional study.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Mean CD4/CD8 ratios over time in HIV-positive WIHS women. Several cross-sectional studies have observed higher CD4/CD8 ratios in older vs. younger healthy adults.– It is unclear whether the higher mean CD4/CD8 ratios observed at later vs. earlier WIHS visits shown in figure reflect (1) age-related increases in CD4/CD8 ratios, (2) increases in CD4/CD8 ratios due to improvements in HIV treatment and clinical care since 1994, (3) unmeasured factors, or (4) a combination of (1–3).
FIGURE 2
FIGURE 2
Mean CD4 T-cell levels over time in HIV-positive WIHS women.
FIGURE 3
FIGURE 3
Mean CD8 T-cell levels over time in HIV-positive WIHS women.
See this image and copyright information in PMC

References

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