CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies

被引：21

作者：

Caby, Fabienne ^{[1
,2
]}

Guiguet, Marguerite ^{[2
]}

Weiss, Laurence ^{[3
]}

Winston, Alan ^{[4
]}

Miro, Jose M. ^{[5
]}

Konopnicki, Deborah ^{[6
]}

Le Moing, Vincent ^{[7
]}

Bonnet, Fabrice ^{[8
,9
]}

Reiss, Peter ^{[10
,11
]}

Mussini, Cristina ^{[12
]}

Poizot-Martin, Isabelle ^{[13
]}

Taylor, Ninon ^{[14
]}

Skoutelis, Athanasios ^{[15
]}

Meyer, Laurence ^{[16
]}

Goujard, Cecile ^{[17
]}

Bartmeyer, Barbara ^{[18
]}

Boesecke, Christoph ^{[19
,20
]}

Antinori, Andrea ^{[21
]}

Quiros-Roldan, Eugenia ^{[22
]}

Wittkop, Linda ^{[23
,24
]}

Frederiksen, Casper ^{[25
]}

Castagna, Antonella ^{[26
]}

Thurnheer, Maria Christine ^{[27
]}

Svedhem, Veronica ^{[28
,29
]}

Jose, Sophie ^{[30
]}

Costagliola, Dominique ^{[2
]}

Mary-Krause, Murielle ^{[2
]}

Grabar, Sophie ^{[2
,31
]}

机构：

[1] Hop Victor Dupouy, Unite VIH IST, Serv Immunohematol, Argenteuil, France

[2] Sorbonne Univ, Inst Pierre Louis Epidemiol & Sante Publ IPLESP, INSERM, F-75013 Paris, France

[3] Univ Paris, Paris Ctr Hotel Dieu, Assistance Publ Hop Paris AP HP, Paris, France

[4] Imperial Coll London, Dept Infect Dis, London, England

[5] Univ Barcelona, Hosp Clin IDIBAPS, Infect Dis Serv, Barcelona, Spain

[6] Univ Libre Bruxelles, St Pierre Univ Hosp, Brussels, Belgium

[7] Univ Hosp Montpellier, Dept Infect Dis, Montpellier, France

[8] Univ Bordeaux, CHU Bordeaux, Bordeaux, France

[9] Univ Bordeaux, INSERM U1219, ISPED, Bordeaux, France

[10] HIV Monitoring Fdn, Amsterdam, Netherlands

[11] Univ Amsterdam, Dept Global Hlth, Amsterdam UMC, Amsterdam, Netherlands

[12] Univ Modena & Reggio Emilia, Modena, Italy

[13] Aix Marseille Univ, Hop St Marguerite, AP HM,Serv Immunohematol Clin, INSERM,IRD,SESSTIM,Sci Econ & Sociales Sante & Tr, Marseille, France

[14] Paracelsus Private Med Univ Salzburg, Dept Dermatol, Salzburg, Austria

[15] Evangelismos Gen Hosp Athens, Dept Med & Infect Dis 5, Athens, Greece

[16] Univ Paris Saclay, Bicetre Hosp, AP HP, INSERM,CESP,U1018, Le Kremlin Bicetre, France

[17] Univ Paris Saclay, Fac Med, Hop Bicetre,Ctr Rech Epidemiol & Sante Populat CE, AP HP,Serv Med Interne & Immunol Clin,Inserm U101, Le Kremlin Bicetre, France

[18] Robert Koch Inst, Dept Infect Dis Epidemiol, Berlin, Germany

[19] German Ctr Infect Res, Cologne, Germany

[20] Bonn Univ Hosp, Dept Med 1, Bonn, Germany

[21] IRCCS, HIV AIDS Dept, Natl Inst Infect Dis, Lazzaro Spallanzani, Rome, Italy

[22] Univ Brescia, Dept Infect & Trop Dis, ASST Spedali Civili Brescia, Brescia, Italy

[23] Univ Bordeaux, Bordeaux Populat Hlth Res Ctr, Team MORPH3EUS, INSERM,UMR 1219,ISPED, Bordeaux, France

[24] CHU Bordeaux, Pole Sante Publ, Serv Informat Med, Bordeaux, France

[25] Univ Copenhagen, Sect Forens Genet, Copenhagen, Denmark

[26] Univ Vita Salute San Raffaele, IRCC San Raffaele, Milan, Italy

[27] Univ Bern, Univ Hosp Berne, Div Infect Dis, Bern, Switzerland

[28] Karolinska Univ Hosp, Dept Infect Dis, Stockholm, Sweden

[29] Karolinska Inst, Dept Med Huddinge, Unit Infect Dis, Stockholm, Sweden

[30] Natl Canc Registrat & Anal Serv, Transforming Canc Serv Team Publ Hlth England Par, Wellington House, London, England

[31] Univ Paris, Unite Biostat & Epidemiol, Hop Cochin, Assistance Publ Hopitaux Paris AP HP, Paris, France

来源：

CLINICAL INFECTIOUS DISEASES | 2021年 / 73卷 / 01期

关键词：

Kaposi sarcoma; non-Hodgkin lymphoma; CD4/CD8; ratio; CD8; T-cells; efficient cART; COMBINATION ANTIRETROVIRAL THERAPY; IMMUNE ACTIVATION; AIDS; INDIVIDUALS; MARKERS; EVENTS; CANCER;

D O I：

10.1093/cid/ciaa1137

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. A persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), still among the most frequent cancers in treated PLWH. Methods. PLWH from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) were included if they achieved virological control (viral load <= 500 copies/mL) within 9 months following cART and without previous KS/LNH diagnosis. Cox models were used to identify factors associated with KS or NHL risk, in all participants and those with CD4 >= 500/mm(3) at virological control. We analyzed the CD4/CD8 ratio, CD4 count and CD8 count as time-dependent variables, using spline transformations. Results. We included 56 708 PLWH, enrolled between 2000 and 2014. At virological control, the median (interquartile range [IQR]) CD4 count, CD8 count, and CD4/CD8 ratio were 414 (296-552)/mm(3), 936 (670-1304)/mm(3), and 0.43 (0.28-0.65), respectively. Overall, 221 KS and 187 NHL were diagnosed 9 (2-37) and 18 (7-42) months after virological control. Low CD4/CD8 ratios were associated with KS risk (hazard ratio [HR] = 2.02 [95% confidence interval {CI} = 1.23-3.31]) when comparing CD4/CD8 = 0.3 to CD4/CD8 = 1) but not with NHL risk. High CD8 counts were associated with higher NHL risk (HR = 3.14 [95% CI = 1.58-6.22]) when comparing CD8 = 3000/mm(3) to CD8 = 1000/mm(3)). Similar results with increased associations were found in PLWH with CD4 >= 500/mm(3) at virological control (HR = 3.27 [95% CI = 1.60-6.56] for KS; HR = 5.28 [95% CI = 2.17-12.83] for NHL). Conclusions. Low CD4/CD8 ratios and high CD8 counts despite effective cART were associated with increased KS/NHL risks respectively, especially when CD4 >= 500/mm(3).

引用

页码：50 / 59

页数：10

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