In this section
@article{Pollock:2018:10.1097/MD.0000000000009798,
author = {Pollock, KM and Pintilie, H and Foster, C and Fidler, S},
doi = {10.1097/MD.0000000000009798},
journal = {Medicine},
title = {Cross-sectional study of CD4:CD8 ratio recovery in young adults with perinatally acquired HIV-1 infection},
url = {http://dx.doi.org/10.1097/MD.0000000000009798},
volume = {97},
year = {2018}
}
TY - JOUR
AB - Antiretroviral therapy (ART) has improved survival into adulthood for young people with perinatally acquired HIV-1 (yp-PaHIV), butlong-term prognosis remains unclear. We hypothesized that on-going immune activation, reflected in the failure of CD4:CD8 rationormalization would be observed in yp-PaHIV, despite ART.A cross-sectional study of routinely collected clinical data from a cohort of yp-PaHIV (≥16 years).Data were collected from records of individuals attending a specialist clinic for yp-PaHIV transitioning to adult care. CD4:CD8 ratioand proportion with CD4:CD8 ratio≥1, demographic data and viral parameters, including HIV-1 viral load (VL) and humancytomegalovirus (CMV) IgG, were analyzed with IBM SPSS Statistics v22.A total of 115 yp-PaHIV, median (IQR) age 22.0 (20.0–24.0) years, were studied, of whom 59 were females, and the majority wereBlack African 75/115 (65.2%). Where measured, CMV antibodies were frequently detected (71/74, 95.9%) and CMV IgG titre wasinversely associated with CD4:CD8 ratio, (Rho 0.383,P=.012). Of those taking ART, 69 out of 90 (76.7%) yp-PaHIV hadsuppressed HIV viremia (<50 RNA copies/mL) and recovery of CD4:CD8 ratio to≥1 was seen in 26 out of 69 (37.7%)with suppressed HIV viremia. Persistence of low CD4:CD8 ratio was observed even in those with a CD4 count≥500cells/mL, where28/52 (53.8%) had a CD4:CD8 ratio<1. Of those with suppressed viremia, the median (IQR) age for starting ART was 8.0 (5.0–12.8)years and CD4:CD8 ratio was inversely associated with age at ART start, Rho 0.348, (P=.028).In this cohort of yp-PaHIV, despite lifelong HIV infection and widespread CMV coinfection, CD4:CD8 ratio recovery rate wascomparable to adults treated in acute infection. Where persistence of CD4:CD8 ratio abnormality was observed, on-going immuneactivation may have significance for non-AIDS outcomes. Taken together ourfindings indicate immune resilience to be a feature ofthese adult survivors of perinatally acquired
AU - Pollock,KM
AU - Pintilie,H
AU - Foster,C
AU - Fidler,S
DO - 10.1097/MD.0000000000009798
PY - 2018///
SN - 0025-7974
TI - Cross-sectional study of CD4:CD8 ratio recovery in young adults with perinatally acquired HIV-1 infection
T2 - Medicine
UR - http://dx.doi.org/10.1097/MD.0000000000009798
VL - 97
ER -