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Chammartin, Frédérique; Mocroft, Amanda; Egle, Alexander; Zangerle, Robert; Smith, Colette; Mussini, Cristina; Wit, Ferdinand; Vehreschild, Jörg Janne; d’Arminio Monforte, Antonella; Castagna, Antonella; Bailly, Laurent; Bogner, Johannes; de Wit, Stéphane; Matulionyte, Raimonda; Law, Matthew; Svedhem, Veronica; Tallada, Joan; Garges, Harmony P; Marongiu, Andrea; Borges, Álvaro H; Jaschinski, Nadine; Neesgaard, Bastian; Ryom, Lene; Bucher, Heiner C; [...]

Measures of Longitudinal Immune Dysfunction and Risk of AIDS and Non-AIDS Defining Malignancies in Antiretroviral-Treated People With Human Immunodeficiency Virus

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  • Media type: E-Article
  • Title: Measures of Longitudinal Immune Dysfunction and Risk of AIDS and Non-AIDS Defining Malignancies in Antiretroviral-Treated People With Human Immunodeficiency Virus
  • Contributor: Chammartin, Frédérique; Mocroft, Amanda; Egle, Alexander; Zangerle, Robert; Smith, Colette; Mussini, Cristina; Wit, Ferdinand; Vehreschild, Jörg Janne; d’Arminio Monforte, Antonella; Castagna, Antonella; Bailly, Laurent; Bogner, Johannes; de Wit, Stéphane; Matulionyte, Raimonda; Law, Matthew; Svedhem, Veronica; Tallada, Joan; Garges, Harmony P; Marongiu, Andrea; Borges, Álvaro H; Jaschinski, Nadine; Neesgaard, Bastian; Ryom, Lene; Bucher, Heiner C; [...]
  • imprint: Oxford University Press (OUP), 2024
  • Published in: Clinical Infectious Diseases
  • Language: English
  • DOI: 10.1093/cid/ciad671
  • ISSN: 1058-4838; 1537-6591
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Human immunodeficiency virus (HIV) infection leads to chronic immune activation/inflammation that can persist in virally suppressed persons on fully active antiretroviral therapy (ART) and increase risk of malignancies. The prognostic role of low CD4:CD8 ratio and elevated CD8 cell counts on the risk of cancer remains unclear.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We investigated the association of CD4:CD8 ratio on the hazard of non-AIDS defining malignancy (NADM), AIDS-defining malignancy (ADM) and most frequent group of cancers in ART-treated people with HIV (PWH) with a CD4 and CD8 cell counts and viral load measurements at baseline. We developed Cox proportional hazard models with adjustment for known confounders of cancer risk and time-dependent cumulative and lagged exposures of CD4:CD8 ratio to account for time-evolving risk factors and avoid reverse causality.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>CD4:CD8 ratios below 0.5, compared to above 1.0, were independently associated with a 12-month time-lagged higher risk of ADM and infection-related malignancies (adjusted hazard ratio 2.61 [95% confidence interval {CI }1.10–6.19] and 2.03 [95% CI 1.24–3.33], respectively). CD4 cell counts below 350 cells/μL were associated with an increased risk of NADMs and ADMs, as did infection, smoking, and body mass index-related malignancies.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In ART-treated PWH low CD4:CD8 ratios were associated with ADM and infection-related cancers independently from CD4 and CD8 cell counts and may alert clinicians for cancer screening and prevention of NADM.</jats:p> </jats:sec>