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CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART: Antiretroviral Therapy Cohort Collaboration

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CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART : Antiretroviral Therapy Cohort Collaboration. / Trickey, Adam; May, Margaret T.; Schommers, Philipp; Tate, Jan; Ingle, Suzanne M.; Guest, Jodie L.; Gill, M. John; Zangerle, Robert; Saag, Mike; Reiss, Peter; Monforte, Antonella D.Arminio; Johnson, Margaret; Lima, Viviane D.; Sterling, Tim R.; Cavassini, Matthias; Wittkop, Linda; Costagliola, Dominique; Sterne, Jonathan A.C.

In: Clinical Infectious Diseases, Vol. 65, No. 6, cix466, 15.09.2017, p. 959-966.

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Trickey, A, May, MT, Schommers, P, Tate, J, Ingle, SM, Guest, JL, Gill, MJ, Zangerle, R, Saag, M, Reiss, P, Monforte, ADA, Johnson, M, Lima, VD, Sterling, TR, Cavassini, M, Wittkop, L, Costagliola, D & Sterne, JAC 2017, 'CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART: Antiretroviral Therapy Cohort Collaboration', Clinical Infectious Diseases, vol. 65, no. 6, cix466, pp. 959-966. https://doi.org/10.1093/cid/cix466

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Trickey, Adam ; May, Margaret T. ; Schommers, Philipp ; Tate, Jan ; Ingle, Suzanne M. ; Guest, Jodie L. ; Gill, M. John ; Zangerle, Robert ; Saag, Mike ; Reiss, Peter ; Monforte, Antonella D.Arminio ; Johnson, Margaret ; Lima, Viviane D. ; Sterling, Tim R. ; Cavassini, Matthias ; Wittkop, Linda ; Costagliola, Dominique ; Sterne, Jonathan A.C. / CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART : Antiretroviral Therapy Cohort Collaboration. In: Clinical Infectious Diseases. 2017 ; Vol. 65, No. 6. pp. 959-966.

Bibtex

@article{285b04f191f049bd9ec9792cf5687625,
title = "CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART: Antiretroviral Therapy Cohort Collaboration",
abstract = "Background. We investigated whether CD4:CD8 ratio and CD8 count were prognostic for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients with high CD4 count. Methods. We used data from 13 European and North American cohorts of human immunodeficiency virus-infected, antiretroviral therapy (ART)-naive adults who started ART during 1996-2010, who were followed from the date they had CD4 count ≥350 cells/μL and were virologically suppressed (baseline). We used stratified Cox models to estimate unadjusted and adjusted (for sex, people who inject drugs, ART initiation year, and baseline age, CD4 count, AIDS, duration of ART) all-cause and cause-specific mortality hazard ratios for tertiles of CD4:CD8 ratio (0-0.40, 0.41-0.64 [reference], >0.64) and CD8 count (0-760, 761-1138 [reference], >1138 cells/μL) and examined the shape of associations using cubic splines. Results. During 276 526 person-years, 1834 of 49 865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509 unknown/ unclassifiable deaths). There was little evidence that CD4:CD8 ratio was prognostic for all-cause mortality after adjustment for other factors: The adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95{\%} confidence interval [CI], 1.00-1.25). The association of CD8 count with all-cause mortality was U-shaped: AHR for higher vs middle tertile was 1.13 (95{\%} CI, 1.01-1.26). AIDSrelated mortality declined with increasing CD4:CD8 ratio and decreasing CD8 count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic for non-AIDS mortality. Conclusions. In this large cohort collaboration, the magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality was too small for them to be useful as independent prognostic markers in virally suppressed patients on ART.",
keywords = "Antiretroviral therapy, Cd4:cd8 ratio, Cd8 count, HIV, Mortality",
author = "Adam Trickey and May, {Margaret T.} and Philipp Schommers and Jan Tate and Ingle, {Suzanne M.} and Guest, {Jodie L.} and Gill, {M. John} and Robert Zangerle and Mike Saag and Peter Reiss and Monforte, {Antonella D.Arminio} and Margaret Johnson and Lima, {Viviane D.} and Sterling, {Tim R.} and Matthias Cavassini and Linda Wittkop and Dominique Costagliola and Sterne, {Jonathan A.C.}",
year = "2017",
month = "9",
day = "15",
doi = "10.1093/cid/cix466",
language = "English",
volume = "65",
pages = "959--966",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "6",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - CD4:CD8 ratio and CD8 count as prognostic markers for mortality in HIV-positive patients on ART

T2 - Antiretroviral Therapy Cohort Collaboration

AU - Trickey, Adam

AU - May, Margaret T.

AU - Schommers, Philipp

AU - Tate, Jan

AU - Ingle, Suzanne M.

AU - Guest, Jodie L.

AU - Gill, M. John

AU - Zangerle, Robert

AU - Saag, Mike

AU - Reiss, Peter

AU - Monforte, Antonella D.Arminio

AU - Johnson, Margaret

AU - Lima, Viviane D.

AU - Sterling, Tim R.

AU - Cavassini, Matthias

AU - Wittkop, Linda

AU - Costagliola, Dominique

AU - Sterne, Jonathan A.C.

PY - 2017/9/15

Y1 - 2017/9/15

N2 - Background. We investigated whether CD4:CD8 ratio and CD8 count were prognostic for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients with high CD4 count. Methods. We used data from 13 European and North American cohorts of human immunodeficiency virus-infected, antiretroviral therapy (ART)-naive adults who started ART during 1996-2010, who were followed from the date they had CD4 count ≥350 cells/μL and were virologically suppressed (baseline). We used stratified Cox models to estimate unadjusted and adjusted (for sex, people who inject drugs, ART initiation year, and baseline age, CD4 count, AIDS, duration of ART) all-cause and cause-specific mortality hazard ratios for tertiles of CD4:CD8 ratio (0-0.40, 0.41-0.64 [reference], >0.64) and CD8 count (0-760, 761-1138 [reference], >1138 cells/μL) and examined the shape of associations using cubic splines. Results. During 276 526 person-years, 1834 of 49 865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509 unknown/ unclassifiable deaths). There was little evidence that CD4:CD8 ratio was prognostic for all-cause mortality after adjustment for other factors: The adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95% confidence interval [CI], 1.00-1.25). The association of CD8 count with all-cause mortality was U-shaped: AHR for higher vs middle tertile was 1.13 (95% CI, 1.01-1.26). AIDSrelated mortality declined with increasing CD4:CD8 ratio and decreasing CD8 count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic for non-AIDS mortality. Conclusions. In this large cohort collaboration, the magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality was too small for them to be useful as independent prognostic markers in virally suppressed patients on ART.

AB - Background. We investigated whether CD4:CD8 ratio and CD8 count were prognostic for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients with high CD4 count. Methods. We used data from 13 European and North American cohorts of human immunodeficiency virus-infected, antiretroviral therapy (ART)-naive adults who started ART during 1996-2010, who were followed from the date they had CD4 count ≥350 cells/μL and were virologically suppressed (baseline). We used stratified Cox models to estimate unadjusted and adjusted (for sex, people who inject drugs, ART initiation year, and baseline age, CD4 count, AIDS, duration of ART) all-cause and cause-specific mortality hazard ratios for tertiles of CD4:CD8 ratio (0-0.40, 0.41-0.64 [reference], >0.64) and CD8 count (0-760, 761-1138 [reference], >1138 cells/μL) and examined the shape of associations using cubic splines. Results. During 276 526 person-years, 1834 of 49 865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509 unknown/ unclassifiable deaths). There was little evidence that CD4:CD8 ratio was prognostic for all-cause mortality after adjustment for other factors: The adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95% confidence interval [CI], 1.00-1.25). The association of CD8 count with all-cause mortality was U-shaped: AHR for higher vs middle tertile was 1.13 (95% CI, 1.01-1.26). AIDSrelated mortality declined with increasing CD4:CD8 ratio and decreasing CD8 count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic for non-AIDS mortality. Conclusions. In this large cohort collaboration, the magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality was too small for them to be useful as independent prognostic markers in virally suppressed patients on ART.

KW - Antiretroviral therapy

KW - Cd4:cd8 ratio

KW - Cd8 count

KW - HIV

KW - Mortality

UR - http://www.scopus.com/inward/record.url?scp=85031933606&partnerID=8YFLogxK

U2 - 10.1093/cid/cix466

DO - 10.1093/cid/cix466

M3 - Article

VL - 65

SP - 959

EP - 966

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 6

M1 - cix466

ER -