Inversion of CD4:CD8 ratio in 50 cutaneous biopsies of patients with Kaposi sarcoma and human immunodeficiency virus infection: A cross‐sectional, descriptive, and observational study in a single dermatology center

• Published in: Health science reports 2024-02, Vol.7 (2), p.e1855-n/a
• Main Authors: García‐Irigoyen, Alejandro, Guzmán‐Bucio, Simón, Aranda‐Audelo, Mercedes, Moore, Zonía R., Trinidad‐Bibiano, Héctor, Elisa, Vega‐Memije María
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Biopsy; CD4:CD8 ratio; Conflicts of interest; Dermatology; exhausted lymphocytes; HIV; Human immunodeficiency virus; Immune system; Infections; Kaposi sarcoma; Kaposis sarcoma; Lymphocytes; Observational studies; Software; Vascular endothelial growth factor; Viral infections
• ISSN: 2398-8835; 2398-8835
• DOI: 10.1002/hsr2.1855

During infection, HIV generates a decrease in the number of CD4+ TL simultaneous to a consistent activation and expansion of CD8+ TL, which results in a low or inverted serum CD4:CD8 ratio. 2 A low serum CD4:CD8 ratio is associated with depletion and senescence of CD4+ TL, as well as increased activation of CD8+ TL. 3 Recently, Caby et al., found that a serum CD4:CD8 ratio of ≤0.3 is a risk factor for the development of KS, despite combination of antiretroviral treatment (c-ART) and a CD4+ TL count ≥500 cells/mm3. 4 Similarly, Poizot-Martin et al., found this risk factor with a serum CD4:CD8 ratio ≤0.5 regardless of the CD4+ TL count. [...]we divided the distribution of CD8+ TL in five patterns: perivascular-peritumoral (defined as an infiltrate around the vascular and spindle cell proliferation of KS), perivascular-peritumoral and peri-adnexal, perivascular-peritumoral and interstitial, and interstitial-only. Elevation of CD8+ TL is associated with increased immune energy and risks of non-acquired immunodeficiency syndrome-related clinical events in HIV-infected patients during c-ART. 4,8,9 All patients with virological suppression (plasma HIV RNA