HIV 感染者衰老过程中衰弱、CD4 计数和 CD4/CD8 比值之间的动态关联。
The dynamic association between Frailty, CD4 and CD4/CD8 ratio in people aging with HIV.
机构信息
Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.
Department of Infectious Diseases, Hospital Beatriz Ângelo, Loures, Portugal.
出版信息
PLoS One. 2019 Feb 14;14(2):e0212283. doi: 10.1371/journal.pone.0212283. eCollection 2019.
OBJECTIVE
To investigate the association between current CD4+ T-cell count and CD4/CD8+ ratio with severity of frailty among people aging with HIV.
METHODS
Cross-sectional observational study analysing data from all study visits in the ongoing prospective Modena HIV Metabolic Clinic Cohort between 2006 and 2015. Frailty severity was assessed using a frailty index (FI). We visualized the relationships between frailty index score and current CD4 cell count and CD4/CD8 ratio on two different curves adjusted for age, sex, and duration of HIV infection.
RESULTS
Frailty index scores exhibited an inverse relationship with current CD4 count, up to 900 cells/μL. The CD4/CD8 ratio was inversely correlated with frailty index both below and above the cut-off of 900 CD4 cells/μL.
CONCLUSIONS
Frailty in PLWH is inversely associated with both immune-activation, depicted by CD4/CD8 ratio and immune-deficit depicted by CD4 count. The first association shows a linear shape while the second shows a hook-shape with a turning point at 900 cells. Above this cut off level CD4 do not represent a significant risk factor for frailty.
目的
研究 HIV 感染者的 CD4+T 细胞计数和 CD4/CD8+比值与虚弱严重程度之间的关联。
方法
这是一项横断面观察性研究，分析了 2006 年至 2015 年期间正在进行的前瞻性莫德纳 HIV 代谢临床队列的所有研究访问中的数据。使用虚弱指数（FI）评估虚弱严重程度。我们在两条不同的曲线上可视化了 FI 评分与当前 CD4 细胞计数和 CD4/CD8 比值之间的关系，这些曲线分别调整了年龄、性别和 HIV 感染持续时间。
结果
FI 评分与当前 CD4 计数呈负相关，直至 900 个细胞/μL。CD4/CD8 比值与 FI 均呈负相关，低于和高于 900 个 CD4 细胞/μL 的截断值。
结论
PLWH 的虚弱与免疫激活（由 CD4/CD8 比值表示）和免疫缺陷（由 CD4 计数表示）均呈负相关。第一个关联呈线性，第二个关联呈钩形，在 900 个细胞处有一个转折点。在此截断值以上，CD4 不再是虚弱的显著危险因素。
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