CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Marco Floridia¹, Carmela Pinnetti², Giulia Masuelli³, Arsenio Spinillo⁴, Valeria M Savasi⁵, Giuseppina Liuzzi², Anna M Degli Antoni⁶, Matilde Sansone⁷, Giovanni Guaraldi⁸, Serena Dalzero⁹, Gianpaolo Maso¹⁰, Daniela Francisci¹¹, Gaetana Sterrantino¹², Marina Ravizza⁹, Enrica Tamburrini¹³; Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy

Collaborators, Affiliations

Collaborators

Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy:
M Floridia, M Ravizza, E Tamburrini, M Ravizza, E Tamburrini, F Di Lorenzo, G Sterrantino, M Meli, I Campolmi, F Vichi, B Del Pin, R Marocco, C Mastroianni, V S Mercurio, D Zanaboni, G Guaraldi, G Nardini, C Stentarelli, B Beghetto, A M Degli Antoni, A Molinari, M P Crisalli, A Donisi, A Ruggieri, M Piepoli, V Cerri, G Zuccotti, V Giacomet, L Paradiso, F Forlanini, E Longoni, G Placido, P Milini, F Savalli, F Sabbatini, D Francisci, C Papalini, L Bernini, P Grossi, L Rizzi, V Portelli, G Maso, M Bernardon, S Bussolaro, I Della Pietà, A Sorz, A Meloni, A Chiodo, M Dedoni, F Ortu, P Piano, A Citernesi, I Bordoni Vicini, K Luzi, A Spinillo, M Roccio, A Vimercati, D Calabretti, S Gigante, B Guerra, F Cervi, G Simonazzi, E Margarito, M G Capretti, C Marsico, G Faldella, M Sansone, P Martinelli, A Agangi, A Capone, G M Maruotti, C Tibaldi, L Trentini, T Todros, G Masuelli, V Frisina, V Savasi, E Cardellicchio, C Giaquinto, M Fiscon, E Rubino, L Franceschetti, R Badolato, M A Forleo, B Tassis, M Ruggiero, O Genovese, C Cafforio, C Pinnetti, G Liuzzi, A M Casadei, A F Cavaliere, M Cellini, A M Marconi, S Dalzero, M Ierardi, S C Simonetti, N Alfieri, S Agrati, C Polizzi, A Mattei, M F Pirillo, R Amici, C M Galluzzo, S Donnini, S Baroncelli, M Floridia, A Cerioli, M De Martino, F Parazzini, E Tamburrini, S Vella, P Martinelli, M Ravizza

Affiliations

¹ National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. marco.floridia@iss.it.
² I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
³ Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and University of Turin, Turin, Italy.
⁴ Department of Obstetrics and Gynaecology, IRCCS S. Matteo, Pavia, Italy.
⁵ Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy.
⁶ Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy.
⁷ Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy.
⁸ Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.
⁹ Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
¹⁰ Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
¹¹ Clinic of Infectious Diseases, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.
¹² SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
¹³ Department of Infectious Diseases, Catholic University and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

PMID: 33963983
DOI: 10.1007/s15010-021-01619-4

CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Marco Floridia et al. Infection. 2021 Oct.

. 2021 Oct;49(5):955-964.

doi: 10.1007/s15010-021-01619-4. Epub 2021 May 8.

Authors

Collaborators

Italian Group on Surveillance of Antiretroviral Treatment in Pregnancy:
M Floridia, M Ravizza, E Tamburrini, M Ravizza, E Tamburrini, F Di Lorenzo, G Sterrantino, M Meli, I Campolmi, F Vichi, B Del Pin, R Marocco, C Mastroianni, V S Mercurio, D Zanaboni, G Guaraldi, G Nardini, C Stentarelli, B Beghetto, A M Degli Antoni, A Molinari, M P Crisalli, A Donisi, A Ruggieri, M Piepoli, V Cerri, G Zuccotti, V Giacomet, L Paradiso, F Forlanini, E Longoni, G Placido, P Milini, F Savalli, F Sabbatini, D Francisci, C Papalini, L Bernini, P Grossi, L Rizzi, V Portelli, G Maso, M Bernardon, S Bussolaro, I Della Pietà, A Sorz, A Meloni, A Chiodo, M Dedoni, F Ortu, P Piano, A Citernesi, I Bordoni Vicini, K Luzi, A Spinillo, M Roccio, A Vimercati, D Calabretti, S Gigante, B Guerra, F Cervi, G Simonazzi, E Margarito, M G Capretti, C Marsico, G Faldella, M Sansone, P Martinelli, A Agangi, A Capone, G M Maruotti, C Tibaldi, L Trentini, T Todros, G Masuelli, V Frisina, V Savasi, E Cardellicchio, C Giaquinto, M Fiscon, E Rubino, L Franceschetti, R Badolato, M A Forleo, B Tassis, M Ruggiero, O Genovese, C Cafforio, C Pinnetti, G Liuzzi, A M Casadei, A F Cavaliere, M Cellini, A M Marconi, S Dalzero, M Ierardi, S C Simonetti, N Alfieri, S Agrati, C Polizzi, A Mattei, M F Pirillo, R Amici, C M Galluzzo, S Donnini, S Baroncelli, M Floridia, A Cerioli, M De Martino, F Parazzini, E Tamburrini, S Vella, P Martinelli, M Ravizza

Affiliations

¹ National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy. marco.floridia@iss.it.
² I.N.M.I. Lazzaro Spallanzani, Rome, Italy.
³ Department of Obstetrics and Neonatology, Città della Salute e della Scienza Hospital, and University of Turin, Turin, Italy.
⁴ Department of Obstetrics and Gynaecology, IRCCS S. Matteo, Pavia, Italy.
⁵ Department of Obstetrics and Gynaecology, Luigi Sacco Hospital and University of Milan, Milan, Italy.
⁶ Department of Infectious Diseases and Hepatology, Azienda Ospedaliera di Parma, Parma, Italy.
⁷ Department of Neurosciences, Reproductive and Dentistry Science, University Federico II, Naples, Italy.
⁸ Department of Medical Specialties, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.
⁹ Department of Obstetrics and Gynaecology, DMSD San Paolo Hospital Medical School, University of Milan, Milan, Italy.
¹⁰ Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
¹¹ Clinic of Infectious Diseases, Department of Experimental Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy.
¹² SOD Malattie Infettive e Tropicali, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
¹³ Department of Infectious Diseases, Catholic University and Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

PMID: 33963983
DOI: 10.1007/s15010-021-01619-4

Abstract

Purpose: To evaluate associations between CD4/CD8 ratio and pregnancy outcomes in women with HIV.

Methods: We evaluated, in a national study of pregnant women with HIV receiving antiretroviral treatment (ART), values of CD4/CD8 ratio at entry in pregnancy, changes between first and third trimester, and possible associations with preterm delivery, low birthweight, and HIV-RNA < 50 copies/ml at third trimester in univariate and multivariate analyses.

Results: Among 934 women, 536 (57.4%) were already on ART at conception. CD4/CD8 ratio (baseline value 0.570) increased significantly between the first and third trimesters, particularly in women who started ART in pregnancy (+ 0.163, vs. + 0.036 in women already on treatment). The rate of CD4/CD8 ratio normalization, defined by achieving a ratio ≥ 1 at the third trimester, was 13.2%. In multivariable analyses, women who entered pregnancy with a CD4/CD8 ratio < 0.3, compared to women with ratio ≥ 1, were almost four-times less likely to have third-trimester HIV-RNA < 50 copies/ml (AOR 0.258, 95%CI 0.111-0.601), and more than twice as likely to have preterm delivery (AOR 2.379, 95%CI 1.082-5.232). For preterm delivery, also a baseline CD4/CD8 ratio between 0.3 and 0.45 was significantly associated with an increased risk (AOR: 3.415, 95%CI 1.690-6.900).

Conclusion: We described for the first time independent associations of low CD4/CD8 ratio with preterm delivery and HIV-RNA suppression.

Keywords: CD4; CD4/CD8 ratio; CD8; HIV suppression; Pregnancy; Preterm delivery.

PubMed Disclaimer

References

1. Caby F. Writing committee of the CD4+/CD8+ Ratio Working Group of the French Hospital Database on HIV (FHDH-ANRS CO4). CD4+/CD8+ ratio restoration in long-term treated HIV-1-infected individuals. AIDS. 2017;31:1685–95. - DOI
1. Chereau F, Madec Y, Sabin C, Obel N, Ruiz-mateos E, Chrysos G, et al. Impact of CD4 and CD8 dynamics and viral rebounds on loss of virological control in HIV controllers. PLoS ONE. 2017;12:e0173893. - DOI
1. Davy-Mendez T, Napravnik S, Zakharova O, Kuruc J, Gay C, Hicks CB, et al. Acute HIV infection and CD4/CD8 ratio normalization after antiretroviral therapy initiation. J Acquir Immune Defic Syndr. 2018;79:510–8. - DOI
1. Francis-Morris A, Mackie NE, Eliahoo J, Ramzan F, Fidler S, Pollock KM. Compromised CD4:CD8 ratio recovery in people living with HIV aged over 50 years: an observational study. HIV Med. 2020;21:109–18. - DOI
1. Han WM, Apornpong T, Kerr SJ, Hiransuthikul A, Gatechompol S, Do T, et al. CD4/CD8 ratio normalization rates and low ratio as prognostic marker for non-AIDS defining events among long-term virologically suppressed people living with HIV. AIDS Res Ther. 2018;15:13. - DOI

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

H85E08000200005/Agenzia Italiana del Farmaco, Ministero della Salute

LinkOut - more resources

Full Text Sources
- Springer
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Collaborators

Affiliations

CD4/CD8 ratio in pregnant women with HIV and its association with pregnancy outcome: data from a national study in Italy

Authors

Collaborators

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials