CD4:CD8 Ratio and Non-AIDS Defining Events in Virally Suppressed HIV Infected Patients: Need to Look Beyond CD4+ T-Cell Counts
Journal Title: HIV/AIDS Research and Treatment – Open Journal - Year 2015, Vol 2, Issue 1
Abstract
Antiretroviral therapy has led to improvement in life-expectancy through viral suppression and improved immune status. This brings in the concern about the non-AIDS defining illnesses which are mostly age associated such as cardiovascular disease, stroke, renal disease, liver disease, neurocognitive disorders, and non-AIDS malignancies.1-6 These are reported to be present at comparatively younger ages in HIV-infected patients.7 It also raises questions on the usefulness of CD4 T cell counts in patients with full HIV RNA suppression.2,8 CD4 count remains the most important predictor of clinical progression in people with HIV infection, but it does not predict immune activation in chronic HIV infection and non-AIDS illnesses.9 Several immunological alterations characteristic of HIV infection, such as immune activation and inflammation, are similar to the immunological alterations associated with normal aging. This finding has led to an intersection of the fields of aging and HIV disease, especially with regard to immune alterations. Inversion of the CD4:CD8 ratio (less than 1) has been identified as a hallmark of immunosenescence and an independent predictor of all-cause mortality in the general population.10,11 This information has prompted the evaluation of the CD4:CD8 ratio as a surrogate marker for the risk of morbidity and mortality in HIV-positive people in the current era of Antiretroviral therapy (ART).
Authors and Affiliations
Mallika Alexander
Keywords
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- EP ID EP555223
- DOI 10.17140/ HARTOJ-2-e005
- Views 153
- Downloads 0
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