| Title: |
CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies |
| Authors: |
CABY, Fabienne; GUIGUET, Marguerite; WEISS, Laurence; WINSTON, Alan; MIRO, Jose M.; KONOPNICKI, Deborah; LE MOING, Vincent; BONNET, Fabrice; REISS, Peter; MUSSINI, Cristina; POIZOT-MARTIN, Isabelle; TAYLOR, Ninon; SKOUTELIS, Athanasios; MEYER, Laurence; GOUJARD, Cecile; BARTMEYER, Barbara; BOESECKE, Christoph; ANTINORI, Andrea; QUIROS-ROLDAN, Eugenia; WITTKOP, Linda; FREDERIKSEN, Casper; CASTAGNA, Antonella; THURNHEER, Maria Christine; SVEDHEM, Veronica; JOSE, Sophie; COSTAGLIOLA, Dominique; MARY-KRAUSE, Murielle; GRABAR, Sophie; PROJECT WORKING GROUP FOR THE COLLABORATION OF OBSERVATIONAL, H. I. V. Epidemiological Research Europe In EuroCoord |
| Publication Year: |
2021 |
| Subject Terms: |
Kaposi sarcoma; Non-Hodgkin lymphoma; CD4/CD8 ratio; CD8 T-cells; Efficient cART; Sciences du Vivant [q-bio]/Santé publique et épidémiologie |
| Description: |
BACKGROUND: A persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), still among the most frequent cancers in treated PLWH. METHODS: PLWH from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) were included if they achieved virological control (viral load ≤ 500 copies/mL) within 9 months following cART and without previous KS/LNH diagnosis. Cox models were used to identify factors associated with KS or NHL risk, in all participants and those with CD4 ≥ 500/mm3 at virological control. We analyzed the CD4/CD8 ratio, CD4 count and CD8 count as time-dependent variables, using spline transformations. RESULTS: We included 56 708 PLWH, enrolled between 2000 and 2014. At virological control, the median (interquartile range [IQR]) CD4 count, CD8 count, and CD4/CD8 ratio were 414 (296-552)/mm3, 936 (670-1304)/mm3, and 0.43 (0.28-0.65), respectively. Overall, 221 KS and 187 NHL were diagnosed 9 (2-37) and 18 (7-42) months after virological control. Low CD4/CD8 ratios were associated with KS risk (hazard ratio [HR] = 2.02 [95% confidence interval {CI } = 1.23-3.31]) when comparing CD4/CD8 = 0.3 to CD4/CD8 = 1) but not with NHL risk. High CD8 counts were associated with higher NHL risk (HR = 3.14 [95% CI = 1.58-6.22]) when comparing CD8 = 3000/mm3 to CD8 = 1000/mm3). Similar results with increased associations were found in PLWH with CD4 ≥ 500/mm3 at virological control (HR = 3.27 [95% CI = 1.60-6.56] for KS; HR = 5.28 [95% CI = 2.17-12.83] for NHL). CONCLUSIONS: Low CD4/CD8 ratios and high CD8 counts despite effective cART were associated with increased KS/NHL risks respectively, especially when CD4 ≥ 500/mm3. ; European Union Seventh Framework Programme ; European Network of HIV/AIDS Cohort Studies ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/cid/ciaa1137 |
| Availability: |
https://oskar-bordeaux.fr/handle/20.500.12278/112488; https://hdl.handle.net/20.500.12278/112488; https://doi.org/10.1093/cid/ciaa1137 |
| Rights: |
open ; Pas de Licence CC |
| Accession Number: |
edsbas.54A84A70 |
| Database: |
BASE |