Imperial College London
Portrait Picture

ProfessorJonathanWeber

Faculty of Medicine, Department of Infectious Disease

Director of the AHSC, Professor of Communicable Diseases
 
 
 
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Contact

 

+44 (0)20 7594 3905j.weber

 
 
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Assistant

 

Mrs Siobhan Pigott +44 (0)20 7594 3901

 
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Location

 

2.15Faculty BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Thornhill:2016:10.1097/QAI.0000000000001013,
author = {Thornhill, J and Inshaw, J and Kaleebu, P and Cooper, D and Ramjee, G and Schechter, M and Tambussi, G and Fox, J and Samuel, M and Miro, JM and Weber, J and Porter, K and Fidler, S},
doi = {10.1097/QAI.0000000000001013},
journal = {Journal of Acquired Immune Deficiency Syndromes},
pages = {69--73},
title = {Enhanced normalisation of CD4/CD8 ratio with earlier antiretroviral therapy at Primary HIV Infection.},
url = {http://dx.doi.org/10.1097/QAI.0000000000001013},
volume = {73},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Total CD4 T-cell counts predict HIV disease progression, but do not necessarily reflect normalization of immune function. CD4/CD8 ratio is a marker of immune dysfunction, a prognostic indicator for non-AIDS mortality, and reflects viral reservoir size. Despite ART, recovery of CD4/CD8 ratio in chronic HIV infection is incomplete; we hypothesize enhanced CD4/CD8 ratio recovery with earlier treatment initiation in recently infected individuals. METHODS: CD4 count and CD4/CD8 ratio were analyzed using data from two cohorts: SPARTAC trial, and the UK HIV Seroconverters Cohort where Primary HIV infection (PHI) was defined as within 6 months from estimated date of infection. Using time-to-event methods and Cox proportional hazard models we examined the effect of CD4/CD8 ratio at seroconversion on disease progression (CD4<350 cells/mm/ART initiation), and factors associated with time from ART initiation to CD4/CD8 normalization (ratio >1.0). FINDINGS: Of 573 seroconverters, 482 (84%) had abnormal CD4/CD8 ratios at HIV seroconversion. Individuals with higher CD4/CD8 ratio at seroconversion were significantly less likely to reach the disease progression end point (aHR [95% CI] = 0.52 [0.32, 0.82], p=0.005). The longer the interval between seroconversion and ART initiation (HR [95% CI] =0.98 per month increase [0.97, 0.99], p<0.001) the less likely CD4/CD8 ratio normalization. ART initiation within 6 months from seroconversion was significantly more likely to normalize (HR [95% CI] =2.47 [1.67, 3.67], p<0.001) than those initiating later. INTERPRETATION: The majority of individuals presenting in PHI have abnormal CD4/CD8 ratios. The sooner ART is initiated in PHI the greater the probability of achieving normal CD4/CD8 ratio.
AU  - Thornhill,J
AU  - Inshaw,J
AU  - Kaleebu,P
AU  - Cooper,D
AU  - Ramjee,G
AU  - Schechter,M
AU  - Tambussi,G
AU  - Fox,J
AU  - Samuel,M
AU  - Miro,JM
AU  - Weber,J
AU  - Porter,K
AU  - Fidler,S
DO  - 10.1097/QAI.0000000000001013
EP  - 73
PY  - 2016///
SN  - 0894-9255
SP  - 69
TI  - Enhanced normalisation of CD4/CD8 ratio with earlier antiretroviral therapy at Primary HIV Infection.
T2  - Journal of Acquired Immune Deficiency Syndromes
UR  - http://dx.doi.org/10.1097/QAI.0000000000001013
UR  - http://hdl.handle.net/10044/1/38425
VL  - 73
ER  -
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