The role of CD4/CD8 ratio in predicting clinical outcomes in human immunodeficiency virus(HIV) infected patients

Abstract

Abstract: Objcetive To investigate the role of CD4/CD8 ratio in predicting clinical outcomes in Human Immunodeficiency Virus(HIV) infected Patients with newly antiretroviral treatment(ART).Method Total of 11357 HIV infected patients with newly ART admitted during January 1982 to October 2018 in Shenzhen the Third People's Hospital were analyzed, retrospectively. 10,522 subjects were included in the study due to exclusion of subjects with incomplete information. The clinical characteristics and levels of CD4/CD8 ratio were collected. According to the tertiles of CD4/CD8 ratio [0-0.20, 0.20-0.40 (reference), >0.40], the patients were divided into three groups: CD4/CD8 ratio <0.2 group (3535 cases) , 0.2≤CD4/CD8 ratio <0.4 group (4410 cases)and CD4/CD8 rati≥0.4 group (2577 cases).Result s Of the 10522 subjects, mean age ± Standard Deviation(SD) was (33.64 ± 10.34) years ,mean CD4⁺T-cells ± SD was (246.96±160.26)cells/mm³,mean CD8⁺T-cells ± SD was (898.69 ± 523.28) cells/mm³ and mean CD4/CD8 ratio ± SD was (0.30 ± 0.24). Based on multivariate linear regression analysis, factors associated with the CD4/CD8 ratio were gender,（t-tests 4.135, 95% CI: 0.017~0.046, P<0.001）,opportunistic infections（t-tests -21.609, 95% CI: -0.103~-0.086, P<0.001）, clinical stages of HIV infection with the WHO classification（t-tests -38.782, 95% CI: -0.092~-0.083, P<0.001）,time between HIV diagnosis and ART initiation（t-tests -2.904, 95% CI: -0.022~-0.004, P<0.001） and HIVRNA loads（t-tests -16.385, 95% CI:-0.047~-0.037, P<0.001）. The CD4/CD8 ratio in multivariate analysis was not associated with age (t-tests -1.006, 95% CI: -0.001~-0.000, >0.05), body mass index (t-tests -1.161, 95%CI: -0.002~-0.001, >0.05), and deaths (t-value 0.058, 95% CI: -0.044-0.047, >0.05).Conclusions In this large cohort collaboration, the lower CD4/CD8 ratio in HIV-infected patients with newly ART was associatde with the longer time between HIV diagnosis and ART initiation ,the later clinical stages of HIV infection with the WHO classification and the higher HIVRNA loads,which indicated that more opportunistic infections. This large study showed the use of CD4/CD8 ratio can be used as a prognostic marker for clinical progression of opportunistic infections.

Key words: Human Immunodeficiency Virus, CD4/CD8 ratio, Predictive value, Clinical outcomes

WANG Si-yuan, SUN Li-qing, DUAN Si-qin, SONG Ying, RAO Man, ZHOU Yang. The role of CD4/CD8 ratio in predicting clinical outcomes in human immunodeficiency virus(HIV) infected patients[J]. Electronic Journal of Emerging Infectious Diseases, 2019, 4(2): 91-96.

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