CD4/CD8 ratio and CD8 counts predict CD4 response in HIV-1-infected drug naive and in patients on cART

Sauter, Rafael; Huang, Ronald; Ledergerber, Bruno; Battegay, Manuel; Bernasconi, Enos; Cavassini, Matthias; Furrer, Hansjakob; Hoffmann, Matthias; Rougemont, Mathieu; Günthard, Huldrych F.; Held, Leonhard

doi:10.1097/md.0000000000005094

Cited by 32 publications

(22 citation statements)

References 39 publications

(39 reference statements)

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“…Study SHSC (2016) showed that the CD4/CD8 ratio was an important time-dependent prognostic factor, for the treatment of HIV naive patients and patients treated with cART. Data from this study confirmed the association between HIV/AIDS disease progression and the time needed for normalization of the CD4/CD8 ratio (22,23).…”

Section: Discussionsupporting

confidence: 76%

CD4/CD8 ratio as a predictor for the occurrence of metabolic syndrome in HIV / AIDS patients during 6 months of cART therapy

Gojak

Hadžiosmanović

Baljić

et al. 2019

Journal of Medical Biochemistry

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Summary Background HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. Methods 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study. Results After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05. Conclusions CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.

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Section: Discussionsupporting

confidence: 76%

CD4/CD8 ratio as a predictor for the occurrence of metabolic syndrome in HIV / AIDS patients during 6 months of cART therapy

Gojak

Hadžiosmanović

Baljić

et al. 2019

Journal of Medical Biochemistry

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“…In other predictive research [7], the use of absolute leukocyte count has been proposed as a surrogate to establish the quantity of CD4 + cells, predicting counts < 200 cells/µL 3 with sensitivity and speci city values between 20.2% and 61%. Other predictive approximations have been conducted achieving more precise values [6,15,16] considering other markers such as the CD4+/CD8 + ratio [17] or the CD4 + percentage [18]. More recently, data mining algorithms such as Random Forest [19] have been developed to predict values of CD4 + < 100 cells/µL 3 , obtaining a precision close to 100%.…”

Section: Discussionmentioning

confidence: 99%

Mathematical temporal prediction of CD4+ lymphocytes in HIV/AIDS patients in antiretroviral treatment

Rodriguez

Prieto

Pérez

2020

Preprint

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Background: The measurement of CD4 + lymphocyte count through flow cytometry, is necessary for the following up of HIV-infected patients in antiretroviral therapy, however, populations in low-income countries are limited to this test. For this, values of leukocytes and CD4 + lymphocytes counts greater than 500, between 200 and 500 and lesser than 200 cells were taken from 250 HIV-infected individuals in sequential dates up to three years. Then, temporal series of 12 prototypical patients were analyzed in search of predictive patterns between CD4 + lymphocytes and leukocytes, and then, these patterns were applied with the remaining data in a blind study in order to calculate the probability of success of the methodology for each range and its combinations, as well as sensitivity and specificity values.Results: Five patterns with predictive percentages greater than 99% were found for the distinct conditions of the methodology, with sensitivity and specificity values of 99%.Conclusions: A predictive theoretical simplification was achieved between leukocytes counts and CD4 + lymphocytes. This method could be useful to improve the surveillance and survival of HIV-infected individuals in low-income countries where flow cytometry cannot be afforded.

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“…The mathematical patterns found between leukocytes and CD4 + cell counts as well as the high probability and accurate values for each of the ranges studied, since two were of 1 and the remaining above 0.94, suggesting that this phenomenon is highly deterministic. Different studies have been developed to substitute the value of CD4 + cell through the absolute lymphocyte count (4-7, 15-17) as well as to predict the value of these cells through other variables as viral load (10), data mining (18) or CD4 + /CD8 + ratio (19). However, these proposals do not achieve adequate performances neither possess reproducibility among the different studies conducted, since they present variations according to age and populational groups studied.…”

Section: Discussionmentioning

confidence: 99%

Predictive theory of CD4+ cells in HIV+ patients in antiretroviral therapy

Rodríguez¹,

Herrera

Díaz

2019

Preprint

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Background: Flow cytometry evaluates the number CD4-Positive T-Lymphocytes in patients infected with HIV/AIDS in anti-retroviral management, which orientates therapies towards different targets. Previously, a methodology was designed based on probability and set theories from leukocyte and lymphocyte counts of complete blood count, although predictions in time were not developed, which is why is wanted to establish a methodology of clinical applicability to temporarily forecast the values of CD4+ greater than 500, between 200 and 500 and lesser than 200 from the values of CD4+ and leukocytes of each patient. Methods: From sequential counts of CD4+ and leukocytes of 200 cases, the registries of 10 prototypical patients were observed to establish predictive patterns, and then these patterns were are applied to the remaining patients in a blind study, finding the probability of success of the methodology as well as sensitivity and specificity values. Results: 5 patterns were found with percentages greater than 99% of predictive accuracy for the distinct conditions of the methodology, with values of sensitivity and specificity of 99%. Conclusions: through a mathematical theoretical simplification, a temporal self-organization in the sequence of measurements of leukocytes and CD4+ lymphocytes were established, highlighting the loading of probability in the dynamic of CD4+ counts, useful to conduct more appropriate following ups of patients in anti-retroviral management.

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CD4/CD8 ratio and CD8 counts predict CD4 response in HIV-1-infected drug naive and in patients on cART

Abstract: Supplemental Digital Content is available in the text

Cited by 32 publications

References 39 publications

CD4/CD8 ratio as a predictor for the occurrence of metabolic syndrome in HIV / AIDS patients during 6 months of cART therapy

CD4/CD8 ratio as a predictor for the occurrence of metabolic syndrome in HIV / AIDS patients during 6 months of cART therapy

Mathematical temporal prediction of CD4+ lymphocytes in HIV/AIDS patients in antiretroviral treatment

Predictive theory of CD4+ cells in HIV+ patients in antiretroviral therapy

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