Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 14;14(2):e0212283.
doi: 10.1371/journal.pone.0212283. eCollection 2019.

The dynamic association between Frailty, CD4 and CD4/CD8 ratio in people aging with HIV

Giovanni Guaraldi  1 , Stefano Zona  1 , Ana Rita Silva  2 , Marianna Menozzi  1 , Giovanni Dolci  1 , Jovana Milic  3 , Federica Carli  1 , Cristina Mussini  1
Affiliations

The dynamic association between Frailty, CD4 and CD4/CD8 ratio in people aging with HIV

Giovanni Guaraldi et al. PLoS One. .

Abstract

Objective: To investigate the association between current CD4+ T-cell count and CD4/CD8+ ratio with severity of frailty among people aging with HIV.

Methods: Cross-sectional observational study analysing data from all study visits in the ongoing prospective Modena HIV Metabolic Clinic Cohort between 2006 and 2015. Frailty severity was assessed using a frailty index (FI). We visualized the relationships between frailty index score and current CD4 cell count and CD4/CD8 ratio on two different curves adjusted for age, sex, and duration of HIV infection.

Results: Frailty index scores exhibited an inverse relationship with current CD4 count, up to 900 cells/μL. The CD4/CD8 ratio was inversely correlated with frailty index both below and above the cut-off of 900 CD4 cells/μL.

Conclusions: Frailty in PLWH is inversely associated with both immune-activation, depicted by CD4/CD8 ratio and immune-deficit depicted by CD4 count. The first association shows a linear shape while the second shows a hook-shape with a turning point at 900 cells. Above this cut off level CD4 do not represent a significant risk factor for frailty.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Relationship between mean frailty index and current CD4 cell count.
Using a Lowess smoothing curve, frailty index exhibited a hook-shaped relationship with current CD4 count.
Fig 2
Fig 2. Relationship between mean frailty index and CD4/CD8 ratio.
Frailty index exhibites a hook-shaped relationship with current CD4 count.
Fig 3
Fig 3. GEE linear regression estimates in subpopulation with CD4/CD8 ratio.
Panel A—GEE linear regression estimates for people with CD4 cell counts less than 900/μL. Panel B—GEE linear regression estimates for those with CD4 cell counts >900/μL.
See this image and copyright information in PMC

References

    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013; 381:752–762. 10.1016/S0140-6736(12)62167-9 - DOI - PMC - PubMed
    1. Rodriguez-Mañas L, Fried LP. Frailty in the clinical scenario. Lancet 2015; 385:e7–9. 10.1016/S0140-6736(14)61595-6 - DOI - PubMed
    1. Guaraldi G, Brothers TD, Zona S, Stentarelli C, Carli F, Malagoli A, et al. A frailty index predicts survival and incident multimorbidity independent of markers of HIV disease severity. AIDS 2015; 29:1633–1641. 10.1097/QAD.0000000000000753 - DOI - PubMed
    1. Piggott DA, Muzaale AD, Mehta SH, Brown TT, Patel KV, Leng SX, et al. Frailty, HIV infection, and mortality in an aging cohort of injection drug users. PLoS ONE 2013; 8:e54910 10.1371/journal.pone.0054910 - DOI - PMC - PubMed
    1. Althoff KN, Jacobson LP, Cranston RD, Detels R, Phair JP, Li X, et al. Age, comorbidities, and AIDS predict a frailty phenotype in men who have sex with men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2014; 69:189–198. - PMC - PubMed

Substances