T Lymphocyte Subsets Associated With Prevalent Diabetes in Veterans With and Without Human Immunodeficiency Virus

• Published in: The Journal of infectious diseases 2020-06, Vol.222 (2), p.252-262
• Main Authors: Bailin, Samuel S, McGinnis, Kathleen A, McDonnell, Wyatt J, So-Armah, Kaku, Wellons, Melissa, Tracy, Russell P, Doyle, Margaret F, Mallal, Simon, Justice, Amy C, Freiberg, Matthew S, Landay, Alan L, Wanjalla, Celestine, Koethe, John R
• Format: Article
• Language: English
• Subjects: Adaptive immunity; Aging; Biomarkers - blood; CD38 antigen; CD4 antigen; CD4 Lymphocyte Count; CD4-Positive T-Lymphocytes - immunology; CD8 antigen; CD8-Positive T-Lymphocytes - immunology; Cohort Studies; Cross-Sectional Studies; Diabetes; Diabetes Complications; Diabetes mellitus; Diabetes Mellitus - immunology; Female; Flow cytometry; HIV; HIV Infections - complications; HIV Infections - immunology; Human immunodeficiency virus; Humans; Immunologic Memory; Immunological memory; Lymphocytes; Lymphocytes T; Major and Brief Reports; Male; Memory cells; Middle Aged; Regression Analysis; Risk factors; T-Lymphocyte Subsets - immunology; Veterans
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiaa069

Abstract Background A higher proportion of circulating memory CD4+ T cells is associated with prevalent diabetes mellitus in the general population. Given the broad changes in adaptive immunity, including memory T-cell expansion, and rising prevalence of diabetes in the human immunodeficiency virus (HIV) population, we assessed whether similar relationships were present in persons with HIV (PWH). Methods Multiple CD4+ and CD8+ T-cell subsets were measured by flow cytometry, and prevalent diabetes cases were adjudicated by 2 physicians for PWH and HIV-negative participants in the Veterans Aging Cohort Study. Multivariable logistic regression models evaluated the association of T-cell subsets and diabetes stratified by HIV status, adjusted for cytomegalovirus serostatus and traditional risk factors. Results Among 2385 participants (65% PWH, 95% male, 68% African American), higher CD45RO+ memory CD4+ T cells and lower CD38+ CD4+ T cells were associated with prevalent diabetes, and had a similar effect size, in both the PWH and HIV-negative (P ≤ .05 for all). Lower CD38+CD8+ T cells were also associated with diabetes in both groups. Conclusions The CD4+ and CD8+ T-cell subsets associated with diabetes are similar in PWH and HIV-negative individuals, suggesting that diabetes in PWH may be related to chronic immune activation. T-cell alterations, including memory CD4+ T-cell expansion, are associated with diabetes in both persons with HIV and HIV-negative individuals, suggesting that changes to the T-cell compartment is related to or possibly mediates diabetes in persons with HIV.