The persistence of low CD4/CD8 ratio in chronic HIV-infection, despite ART suppression and normal CD4 levels, is associated with pre-therapy values of inflammation and thymic function

• Published in: Journal of microbiology, immunology and infection immunology and infection, 2024-12, Vol.57 (6), p.854-867
• Main Authors: Garrido-Rodríguez, Vanesa, Bulnes-Ramos, Ángel, Olivas-Martínez, Israel, Pozo-Balado, María del Mar, Álvarez-Ríos, Ana Isabel, Gutiérrez, Félix, Izquierdo, Rebeca, García, Federico, Tiraboschi, Juan Manuel, Vera-Méndez, Francisco, Peraire, Joaquim, Rull, Anna, Pacheco, Yolanda María
• Format: Article
• Language: English
• Subjects: Adult; Antiretroviral Therapy, Highly Active; Biomarkers - blood; CD4 Lymphocyte Count; CD4-CD8 Ratio; CD4-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - immunology; Disease Progression; Female; HIV Infections - drug therapy; HIV Infections - immunology; HIV-Infection; Humans; Immunological dysfunction; Inflammation - immunology; Male; Middle Aged; Nadir-CD4 T-cell; sj/β-TRECs; Thymus Gland - immunology; Viral Load
• ISSN: 1684-1182; 1995-9133; 1995-9133
• DOI: 10.1016/j.jmii.2024.08.007

Persistence of a low CD4/CD8 ratio is associated with an increased morbimortality in people living with HIV (PLWH) under effective antiretroviral therapy. We aimed to explore the immunological significance of a persistently low CD4/CD8 ratio, even despite normal CD4 levels, and assess whether these features vary from those associated to a low nadir-CD4, another well-established predictor of disease progression. CD4-recovered PLWH were classified by CD4/CD8 ratio after three-years of ART (viral suppression, CD4≥500; R  1.2, n = 28). sj/β-TRECs ratio and inflammatory-related markers were quantified. PBMCs were immunophenotyped by CyTOF and functionally characterized by ELISPOT. Subjects were also reclassified depending on nadir-CD4 (N ≤ 350/N > 350). R  1.2 (increased β2-microglobulin, D-dimers and IP-10 before ART). R