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Course and Clinical Significance of CD8+ T-Cell Counts in a Large Cohort of HIV-Infected Individuals.
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- Author(s): Helleberg, Marie1 ; Kronborg, Gitte2; Ullum, Henrik3; Ryder, Lars P.4; Obel, Niels1; Gerstoft, Jan1
- Source:
Journal of Infectious Diseases. 6/1/2015, Vol. 211 Issue 11, p1726-1734. 9p.- Subject Terms:
- Source:
- Additional Information
- Abstract: Objectives. To examine trajectories of CD8+ T-cell counts before and after combination antiretroviral therapy (cART) in human immunodeficiency virus (HIV)-infected individuals and associations with mortality. Methods. CD8+ T-cell counts were measured in 3882 HIV-infected individuals who received care in Copenhagen during 1995-2012. Reference values were obtained from 1230 persons from the background population. Mortality rate ratios were estimated by Poisson regression. Results. CD8+ T-cell counts were elevated during untreated HIV infection and remained elevated through 10 years of cART. A slight drop of 130 cells/μL (interquartile range, -160 to 410 cells/μL) in the median CD8+ T-cell count was observed after cART initiation. CD8+ T-cell counts stabilized at approximately 900 cells/μL (95th percentile of the background population, 835 cells/μL). Markedly elevated CD8+ T-cell counts at cART initiation were associated with a poor increase in the CD4+ T-cell count (relative risk, 2.22; 95% confidence interval [CI], 1.42- 3.48). Individuals with a CD8+ T-cell count of <500 cells/μL 1 year after cART initiation had an increased mortality rate (mortality rate ratio, 1.73; 95% CI, 1.29-2.32) and a higher proportion of deaths attributable to AIDSrelated conditions, compared with individuals with CD8+ T-cell counts of ⩾500 cells/μL. After receiving cART for 10 years, a CD8+ T-cell count of >1500 cells/μL was associated with increased non-AIDS-related mortality (mortality rate ratio, 1.82; 95% CI, 1.09-3.22), compared with a CD4+ T-cell count of 500-1500 cells/μL. Conclusions. CD8+ T-cell counts are elevated during HIV infection and do not normalize despite long-term cART. Low CD8+ T-cell counts are associated with increased AIDS-related mortality. Marked elevations in CD8+ T-cell counts after long-term cART are associated with increased non-AIDS-related mortality. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Journal of Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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