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Association of age at ART initiation with CD4:CD8 ratio recovery among virally suppressed people living with HIV, 2001-2019

Holden, Clare J; Lampe, Fiona C; Burns, Fiona M; Chaloner, Clinton; Johnson, Margaret; Kinloch-De Loes, Sabine; Smith, Colette J; (2023) Association of age at ART initiation with CD4:CD8 ratio recovery among virally suppressed people living with HIV, 2001-2019. AIDS 10.1097/QAD.0000000000003801. (In press).

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Abstract

OBJECTIVE: To investigate the association of age at anti-retroviral therapy (ART) initiation with CD4:CD8 T cell ratio in virally suppressed people with HIV on long-term ART, and to characterize potential CD4:CD8 ratio recovery in this population by age. DESIGN: A longitudinal study of people attending an HIV clinic at the Royal Free Hospital NHS Trust, London, who initiated ART between 2001 and 2015, and achieved and maintained HIV-1 viral suppression (VL<100 c/mL). The association of age group at ART initiation with CD4:CD8 ratio at 5 and 10 years was assessed. METHODS: Multivariable linear regression was used to investigate the relationship between age at ART initiation and log CD4:CD8 ratio, adjusting for demographic factors (gender/HIV transmission route, ethnicity), baseline CD4 count and calendar year. RESULTS: The sample included 1859 people aged 20-78 (75% male, 56% white ethnicity). Overall, median CD4:CD8 T cell ratio increased from 0.24 at baseline to 0.77 at year 5 and 0.88 at year 10. Ratios increased among all age groups in unadjusted and adjusted models but increased less among older ages (baseline ages 60-69 and 70-79). Median ratios at year 5 were 0.85, 0.80, 0.72, 0.76, 0.6 and 0.44 respectively among people aged 20-29, 30-39, 40-49, 50-59, 60-69 and 70-79 years at baseline. CONCLUSIONS: In a virally suppressed London population, age had a substantial impact on CD4:CD8 ratio recovery, especially for those starting ART after age 60. Results may indicate the level of CD4:CD8 ratio recovery possible in an HIV positive, virally suppressed, aging population.

Type: Article
Title: Association of age at ART initiation with CD4:CD8 ratio recovery among virally suppressed people living with HIV, 2001-2019
Location: England
DOI: 10.1097/QAD.0000000000003801
Publisher version: http://doi.org/10.1097/QAD.0000000000003801
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Aging; antiretroviral therapy; CD4:CD8 ratio; HIV
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10182498
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