CD4:CD8 Ratio and CD8 Count as Prognostic Markers for Mortality in Human Immunodeficiency Virus-Infected Patients on Antiretroviral Therapy: The Antiretroviral Therapy Cohort Collaboration (ART-CC).
CD4:CD8 Ratio and CD8 Count as Prognostic Markers for Mortality in Human Immunodeficiency Virus-Infected Patients on Antiretroviral Therapy: The Antiretroviral Therapy Cohort Collaboration (ART-CC).
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DOI：
10.1093/cid/cix466
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发表时间：
2017-09-15
期刊：
影响因子：
--
通讯作者：
Antiretroviral Therapy Cohort Collaboration (ART-CC)
中科院分区：
文献类型：
--
作者：
Trickey A;May MT;Schommers P;Tate J;Ingle SM;Guest JL;Gill MJ;Zangerle R;Saag M;Reiss P;Monforte AD;Johnson M;Lima VD;Sterling TR;Cavassini M;Wittkop L;Costagliola D;Sterne JAC;Antiretroviral Therapy Cohort Collaboration (ART-CC)
CD4/CD8比率或CD8计数与全因死亡率和病因特异性死亡率的相关性太小，不能作为独立的预后标记物，在接受高CD4计数的抗逆转录病毒治疗的病毒抑制患者中，它们还不能作为独立的预后标志。我们调查了在病毒学抑制的高CD_4计数患者中，CD_4/CD_8比率和CD_8计数是否可以预测全因、艾滋病和非艾滋病患者的死亡率。我们使用了13名欧洲和北美人群的数据，这些人感染了人类免疫缺陷病毒，接受了抗逆转录病毒治疗(ART)，他们在1996年至2010年期间开始接受抗逆转录病毒治疗，他们从获得CD4count≥350 Cells/μL起进行了跟踪调查，并进行了病毒学抑制(基线)。我们使用分层COX模型估计了未调整和调整的(性别、注射药物的人、ART开始的年份、基线年龄、CD_4计数、艾滋病、ART持续时间)CD_4：CD_8比率(0-0.40，0.41~0.64[参考文献])和CD_8计数(0~760,761-1138[参考文献]，&gT；1138细胞/μL)的全因和原因特定死亡风险比，并使用三次样条法检验了关联的形状。在276526人年期间，49865名患者中有1 834人死亡(249人与艾滋病有关；1076人与艾滋病无关；509人死亡/无法分类)。在调整了其他因素后，几乎没有证据表明CD4/CD8比率可以预测全因死亡率：调整后的风险比(AHR)为1.11(95%可信区间，1.00-1.25)。CD8计数与全因死亡率呈U型关系：高三分位数的AHR为1.13(95%CI，1.01-1.26)。艾滋病相关死亡率随CD_4/CD_8比值的升高和CD_8计数的降低而降低。几乎没有证据表明，CD4/CD8比率或CD8计数可以预测非艾滋病死亡率。在这一大型队列合作中，调整后的CD4/CD8比率或CD8计数与死亡率的相关性太小，不能作为ART病毒抑制患者的独立预后标志物。
Associations of CD4:CD8 ratio or CD8 count with all-cause and cause-specific mortality were too small for them to be useful as independent prognostic markers in addition to CD4 count in virally suppressed patients on antiretroviral therapy with high CD4 count. We investigated whether CD4:CD8 ratio and CD8 count were prognostic for all-cause, AIDS, and non-AIDS mortality in virologically suppressed patients with high CD4 count. We used data from 13 European and North American cohorts of human immunodeficiency virus–infected, antiretroviral therapy (ART)–naive adults who started ART during 1996–2010, who were followed from the date they had CD4 count ≥350 cells/μL and were virologically suppressed (baseline). We used stratified Cox models to estimate unadjusted and adjusted (for sex, people who inject drugs, ART initiation year, and baseline age, CD4 count, AIDS, duration of ART) all-cause and cause-specific mortality hazard ratios for tertiles of CD4:CD8 ratio (0–0.40, 0.41–0.64 [reference], >0.64) and CD8 count (0–760, 761–1138 [reference], >1138 cells/μL) and examined the shape of associations using cubic splines. During 276526 person-years, 1834 of 49865 patients died (249 AIDS-related; 1076 non-AIDS-defining; 509 unknown/unclassifiable deaths). There was little evidence that CD4:CD8 ratio was prognostic for all-cause mortality after adjustment for other factors: the adjusted hazard ratio (aHR) for lower vs middle tertile was 1.11 (95% confidence interval [CI], 1.00–1.25). The association of CD8 count with all-cause mortality was U-shaped: aHR for higher vs middle tertile was 1.13 (95% CI, 1.01–1.26). AIDS-related mortality declined with increasing CD4:CD8 ratio and decreasing CD8 count. There was little evidence that CD4:CD8 ratio or CD8 count was prognostic for non-AIDS mortality. In this large cohort collaboration, the magnitude of adjusted associations of CD4:CD8 ratio or CD8 count with mortality was too small for them to be useful as independent prognostic markers in virally suppressed patients on ART.
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影响因子：
3.8
作者：
BURCHAM, J;MARMOR, M;PENNY, R
通讯作者：
PENNY, R
DOI：
10.1093/cid/ciu261
发表时间：
2014-07-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Ingle SM;May MT;Gill MJ;Mugavero MJ;Lewden C;Abgrall S;Fätkenheuer G;Reiss P;Saag MS;Manzardo C;Grabar S;Bruyand M;Moore D;Mocroft A;Sterling TR;D'Arminio Monforte A;Hernando V;Teira R;Guest J;Cavassini M;Crane HM;Sterne JA;Antiretroviral Therapy Cohort Collaboration
通讯作者：
Antiretroviral Therapy Cohort Collaboration
影响因子：
--
作者：
Kowalska, Justyna D.;Mocroft, Amanda;Kirk, Ole
通讯作者：
Kirk, Ole
DOI：
10.1097/01.qai.0000437171.00504.41
发表时间：
2014-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
McComsey GA;Kitch D;Sax PE;Tierney C;Jahed NC;Melbourne K;Ha B;Brown TT;Bloom A;Fedarko N;Daar ES
通讯作者：
Daar ES
影响因子：
3
作者：
Hattab, S.;Guiguet, M.;Katlama, C.
通讯作者：
Katlama, C.