HIV/AIDS Prognostics: Time from HIV-1 seroconversion to CD4/CD8 ratio inversion predicts time to AIDS

AIDSWEEKLY Plus; Monday, October 9, 2006
Staff Medical Writers

According to a study from the United States, "HIV-1 infection is characterized by an inverted CD4/CD8 T-cell ratio (CD4/CD8<1), but the distribution of inversions over time after seroconversion and whether delay of inversion is associated with a favorable prognosis are not known.

"T-cell counts and clinical outcomes among men in the Multicenter AIDS Cohort Study who had incident HIV-1 infection before December 31, 1995 were analyzed by Kaplan-Meier and Cox proportional hazards methods."

"Results were also analyzed by time-dependent multivariate methods to adjust for CD4 lymphocyte counts, viral loads, age, race, and polymorphisms in host chemokine receptor genes (CCR5-Delta 32 and CCR2-64I)," investigators said.

"Among 424 cases whose date of seroconversion was known to within ±4.5 months, 317, 52, and 55 inverted their CD4/CD8 ratio within less than 1, 1 to 2, and more than 2 years of seroconversion, respectively.

"Longer time to inversion was significantly associated with longer time to AIDS, even after adjusting for CD4 lymphocyte count and viral load at the first seropositive visit and over the first 3 seropositive visits," reported J.B. Margolick and colleagues at Johns Hopkins University.

"Of the 6 seroconverters who had more than 500 CD4 lymphocytes 10 years after seroconversion without receiving highly active antiretroviral therapy," continued the authors, "5 took more than 2 years to invert their CD4/CD8 ratio."

Researchers concluded, "Time from HIV-1 seroconversion to inversion of the CD4/CD8 ratio independently predicted time to AIDS.

"Early measurements of the CD4/CD8 ratio until inversion occurs may identify people likely to become long-term nonprogressors or slow progressors, thus facilitating detailed studies of the mechanism of HIV-1 disease progression."

Margolick and colleagues published the results of their research in Journal of Acquired Immune Deficiency Syndromes (Impact of inversion of the CD4/CD8 ratio on the natural history of HIV-1 infection. J Acquir Immune Defic Syndr. 2006 Aug 15;42(5):620-6).

For additional information, contact J.B. Margolick, Johns Hopkins University, Bloomberg School Public Health, Dept. of Molecular Microbiology & Immunology, 615 E Wolfe St., Room E5153, Baltimore, MD 21205, USA.

The publisher of the Journal of Acquired Immune Deficiency Syndromes can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Baltimore, Maryland, United States, HIV/AIDS, CD4/CD8 ratio, HIV-1 Disease Progression, Seroconversion, Prognostic Indicator.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Margolick JB, Gange SJ, Detels R, et al., “mpact of inversion of the CD4/CD8 ratio on the natural history of HIV-1 infection”, J Acquir Immune Defic Syndr. 2006 Aug 15;42(5):620-6.

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