CMV+ Serostatus Associates Negatively with CD4:CD8 Ratio Normalization in Controlled HIV-Infected Patients on cART.
Cytomegalovirus (CMV) infection is common among HIV-infected patients but its repercussion on the course of CD4+ and CD8+ T cells after cART initiation remains elusive. The French Dat'AIDS cohort enrolled 5,688 patients on first-line cART, from which we selected patients who achieved HIV suppression for at least 12 months without modification of cART, and for whom CMV serostatus was available. Five hundred and three patients fulfilled the selection criteria (74% male, median age 43 yrs, 15.5% CDC stage C), of whom 444 (88.3%) were seropositive for CMV (CMV+). Multivariate analyses using mixed-linear models adjusted for the time from HIV suppression, sex, age, transmission risk group, duration of HIV follow-up, the interaction between time from HIV suppression and CMV+ serology, and the nadir CD4 count revealed a negative correlation between CMV+ and CD4:CD8 ratio (coeff. = -0.16; p = 0.001). This correlation was also observed among patients displaying optimal CD4 recovery (≥500 cells/mm3 at M12; coeff. = -0.24; p = 0.002). Hence, CMV+ serostatus antagonizes normalization of the CD4:CD8 ratio, although further analyses of the impact of co-morbidities that associate with CMV serostatus, like HCV infection, are needed to elucidate this antagonism formally. However, this might reflect a premature T cell senescence, thus advocating for a close monitoring of T cells in CMV co-infected patients. In addition, our results raise the question of the benefit of treatment for asymptomatic CMV co-infection in HIV-infected patients.
Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic, Marseille, France.|Inserm U912 (SESSTIM), Marseille, France.
Isabelle
I
Poizot-Martin
CHU Hôtel Dieu, Service des maladies infectieuses, Nantes, France.
Clotilde
C
Allavena
APHP- Hôpital Necker-Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, Université Paris Descartes- IHU Imagine Paris, Paris, France.|Institut Pasteur, Centre Médical-Centre d'Infectiologie Necker-Pasteur, Paris, France.|Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France.
Claudine
C
Duvivier
Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic, Marseille, France.
Carla Eliana
CE
Cano
CHU Archet 1, Service de Maladies Infectieuses et Tropicales, Nice, France.
Francine
F
Guillouet de Salvador
Hôpitaux Universitaires Strasbourg, Center for HIV care, Strasbourg, France.
David
D
Rey
Infectious Diseases Department, CHU of Nice, University Nice Sophia-Antipolis, Nice, France.
Pierre
P
Dellamonica
INSERM, UMR 1027, Toulouse III University, CHU Toulouse, COREVIH Toulouse, Toulouse, F-31000, France.
Lise
L
Cuzin
Paris- Descartes University, Sorbonne Paris-Cité, EA 3620, France.|Virology Laboratory, Necker Enfants-Malades Hospital, Paris, France.
Antoine
A
Cheret
Université des Antilles, Faculté de Médecine Hyacinthe Bastaraud, EA 4537, Pointe-à-Pitre, France.|Centre Hospitalier Universitaire de Pointe-à-Pitre, Inserm CIC1424, Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Pointe-à-Pitre, France.
Bruno
B
Hoen
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016516:CD4-CD8 Ratio; D060085:Coinfection / Q000276:immunology / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged
D019380:Anti-HIV Agents