title: CD4:8 Ratio Above 5 Is Associated With All-Cause Mortality in CMV-Seronegative Very Old Women: Results From the BELFRAIL Study.
abstract: The occurrence and general applicability of the CD4:8 ratio as a surrogate predictor of mortality among the oldest old have only been tested in a few longitudinal studies. Here, the predictive value of CD4:8 ratio for mortality with respect to the role of cytomegalovirus (CMV) infection was investigated. Using polychromatic flow cytometry, the CD4:8 ratio and T-cell subsets of 235 individuals aged 81.5 years or older were analyzed, and mortality data were collected after a mean period of 3.3 years. The hazard for all-cause mortality adjusted for age, comorbidity, and CMV serostatus increased 1.53-fold (95% CI: 0.94-2.51) with every increment in the CD4:8 ratio from R < 1, to 1 < R < 5 and R > 5 among women. A negative hazard ratio of 0.50 for CMV seropositivity in women indicated an apparently protective effect of this virus. In men, no associations with survival were observed. No mediation effect could be found for the CD4:8 ratio with respect to the relationship between CMV serostatus and mortality. Very elderly CMV-negative women with a R > 5 experienced the highest mortality rates, independent of age and comorbidity. The associations of CMV serostatus and CD4:8 ratio with mortality seem to reflect distinct pathways mediating life span in very old humans.
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Belgium.|Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Adriaensen
authors.affiliation: Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Germany.|School of Science and Technology, Nottingham Trent University, Nottingham, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Pawelec
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Belgium.|Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vaes
authors.affiliation: Institute of Medical Virology and Epidemiology of Viral Disease, University Hospital, Eberhard-Karls University, Tu¨bingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamprecht
authors.affiliation: Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Germany.
authors.forename: Evelyna
authors.initials: E
authors.lastname: Derhovanessian
authors.affiliation: Department of Public Health and Primary Care, KU Leuven,Belgium.
authors.forename: Gijs
authors.initials: G
authors.lastname: van Pottelbergh
authors.affiliation: Department of Public Health and Primary Care, KU Leuven, Belgium.|Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Degryse
authors.affiliation: Department of Public Health and Primary Care, KU Leuven,Belgium.
authors.forename: Catharina
authors.initials: C
authors.lastname: Matheï
mesh_terms: D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D016516:CD4-CD8 Ratio; D002423:Cause of Death; D015897:Comorbidity; D003586:Cytomegalovirus Infections / Q000097:blood / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D016330:Frail Elderly; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate
keywords: Cytomegalovirus; Mortality; Oldest old; Sex differences; T-cell distribution