title: Association of Hepatitis C Virus Infection With CD4/CD8 Ratio in HIV-Positive Women.
abstract: BACKGROUND
  Recent studies reported that the CD4/CD8 T-cell ratio is inversely associated with biomarkers traditionally used to measure immune activation and systemic inflammation in highly active antiretroviral therapy-treated HIV-infected (HIV+) patients. The relation of hepatitis C virus (HCV) coinfection with the CD4/CD8 ratio in HIV+ patients is unknown.
  
  
  METHODS
  We examined 50,201 CD4/CD8 ratios measured over 20 years in 3 groups of HIV+ women enrolled in the Women's Interagency HIV Study: HCV antibody negative (n = 1734), cleared HCV (n = 231), and chronic HCV (n = 751) in multivariate models. IFNL4-ΔG genotype and HCV viral load were also considered.
  
  
  RESULTS
  Compared with HCV antibody negative status, chronic HCV infection was associated with lower CD4/CD8 ratios when HIV viral load was suppressed to the lower limit of quantification (β = -0.08; P = 0.002). Cleared HCV (β = -0.10; P = 0.0009), but not IFNL4-ΔG genotype or HCV viral load, was also associated with lower CD4/CD8 ratios when HIV viral load was suppressed to the lower limit of quantification.
  
  
  CONCLUSIONS
  The association of HCV coinfection with CD4/CD8 ratio is consistent with previously observed associations of HCV coinfection with biomarkers traditionally used to measure immune activation and systemic inflammation in HIV+ patients. These data provide additional support for the use of CD4/CD8 ratio for routine monitoring of immune activation and inflammation in HIV+ patients, including those with HIV/HCV coinfection; however, the unexpected association between cleared HCV and lower CD4/CD8 ratio requires additional study.
authors.affiliation: *Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY;†Infections and Immunoepidemiology Branch, National Cancer Institute, Bethesda, MD;‡Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD;§Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, NY;‖Department of Medicine, Georgetown University Medical Center, Washington, DC;¶Department of Pediatrics, University of Southern California, Los Angeles, CA;#Department of Medicine, University of California, San Francisco, CA;**Department of Medicine, CORE Center/Stroger Hospital of Cook County, Chicago, IL;††Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; and‡‡Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Kuniholm
authors.forename: Thomas R
authors.initials: TR
authors.lastname: OʼBrien
authors.forename: Ludmila
authors.initials: L
authors.lastname: Prokunina-Olsson
authors.forename: Michael
authors.initials: M
authors.lastname: Augenbraun
authors.forename: Michael
authors.initials: M
authors.lastname: Plankey
authors.forename: Roksana
authors.initials: R
authors.lastname: Karim
authors.forename: Monika
authors.initials: M
authors.lastname: Sarkar
authors.forename: Audrey L
authors.initials: AL
authors.lastname: French
authors.forename: Chris
authors.initials: C
authors.lastname: Pierce
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D060085:Coinfection / Q000276:immunology; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007378:Interleukins / Q000276:immunology; D011446:Prospective Studies; D019562:Viral Load / Q000276:immunology; D000095022:Interferon Lambda
chemical_list: D015415:Biomarkers; D007378:Interleukins; C579163:IFNL4 protein, human; D000095022:Interferon Lambda