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. 2023 Jan 9;23(1):16.
doi: 10.1186/s12879-022-07963-6.

Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV)

Sophie Devos  1   2 , Fabrice Bonnet  1   3   4 , Mojgan Hessamfar  1   2   3 , Didier Neau  5 , Marc-Olivier Vareil  6 , Olivier Leleux  4 , Charles Cazanave  5 , Nicolas Rouanes  7 , Pierre Duffau  3   8 , Estibaliz Lazaro  9 , François Dabis  1   2 , Linda Wittkop  1   4   10   11 , Diana Barger  12 ; ANRS CO3-AQUIVIH-NA-QuAliV
Collaborators, Affiliations

Tobacco, alcohol, cannabis, and illicit drug use and their association with CD4/CD8 cell count ratio in people with controlled HIV: a cross-sectional study (ANRS CO3 AQUIVIH-NA-QuAliV)

Sophie Devos et al. BMC Infect Dis. .

Abstract

Background: To evaluate drug use (alcohol, tobacco, cannabis and other drugs) and its association with mean CD4/CD8 T cell count ratio, a marker of chronic inflammation, in virally suppressed people living with HIV-1 (PLWH) in Nouvelle Aquitaine, France.

Methods: A multi-centric, cross-sectional analysis was conducted in 2018-19 in the QuAliV study-ANRS CO3 AQUIVIH-NA cohort. Tobacco, alcohol, cannabis, and other drug use (poppers, cocaine, amphetamines, synthetic cathinones, GHB/GBL) were self-reported. CD4 and CD8 T cell counts and viral load measures, ± 2 years of self-report, and other characteristics were abstracted from medical records. Univariable and multivariable linear regression models, adjusted for age, sex, HIV risk group, time since HIV diagnosis, and other drug use were fit for each drug and most recent CD4/CD8 ratio.

Results: 660 PLWH, aged 54.7 ± 11.2, were included. 47.7% [315/660] had a CD4/CD8 ratio of < 1. Their mean CD4/CD8 ratio was 1.1 ± 0.6. 35% smoked; ~ 40% were considered to be hazardous drinkers or have alcohol use disorder; 19.9% used cannabis and 11.9% other drugs. Chemsex-associated drug users' CD4/CD8 ratio was on average 0.226 (95% confidence interval [95% CI] - 0.383, - 0.070) lower than that of non-users in univariable analysis (p = 0.005) and 0.165 lower [95% CI - 0.343, 0.012] in multivariable analysis (p = 0.068).

Conclusions: Mean differences in CD4/CD8 ratio were not significantly different in tobacco, alcohol and cannabis users compared to non-users. However, Chemsex-associated drug users may represent a population at risk of chronic inflammation, the specific determinants of which merit further investigation.

Trial registration number: NCT03296202.

Keywords: CD4/CD8 ratio; Chemsex; Chronic inflammation; Drug use; HIV.

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Conflict of interest statement

SD, MH, DN, NR, EL, PD, CC, OL, FD, LW have no relevant financial or non-financial competing interests to disclose. MOV reports financial support from Gilead Sciences, ViiV Healthcare and MSD outside the submitted work (conference participation). FB reports non-financial support from Gilead Sciences, Janssen, ViiV Healthcare, and MSD, personal fees from Gilead Sciences, Janssen, ViiV Healthcare and MSD outside the submitted work. DB has received speaking fees from Gilead Sciences, ViiV Healthcare, and MSD and been compensated as an expert on a Gilead Sciences advisory board outside the submitted work.

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