Ruiz-Manríquez Carlos Alberto, Avila-Funes José Alberto, Brañas Fátima, Crabtree-Ramírez Brenda, Amieva Hélène, Hernández-Ruiz Virgilio
Geriatric Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, 14080, Tlalpan, Mexico City, Mexico.
Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Eur Geriatr Med. 2025 Feb;16(1):305-313. doi: 10.1007/s41999-024-01079-7. Epub 2024 Oct 30.
To ascertain the association between the LT-CD4 + /CD8 + ratio and cognitive impairment in older people living with HIV.
A cross-sectional study was conducted, including 207 adults aged > 50 years with HIV, receiving care at a tertiary-care hospital in Mexico City. Participants underwent a standardized geriatric and neuropsychological assessment to establish the presence of HIV-associated neurocognitive disorder according to the validated Antinori criteria. Multivariate logistic regression models were performed to determine the association between T-CD4 + /CD8 + lymphocyte ratio tercile values (0.57-0.91, and < 0.56; with > 0.91 being the reference category) and cognitive impairment.
Participants' median age was 56 (IQR 53-62) years and 173 (83.6%) were men. The prevalence of any kind of cognitive impairment according to the Antinori criteria was 66.2% (n = 137), the highest proportion being asymptomatic neurocognitive impairment (n = 114, 83.2%). Adjusted logistic regression analyses showed that the lowest LT-CD4 + /CD8 + ratio tercile values (< 0.56) were independently associated with the presence of cognitive impairment (OR 3.16; 95% CI 1.22-8.16, p = 0.017).
Lower LT-CD4 + /CD8 + ratios are independently associated with cognitively impaired older persons with HIV, which represents another factor that could be addressed to identify individuals at risk and focus on cognitive screening as well as correction of other modifiable risk factors.
确定HIV感染老年人的淋巴细胞毒性T细胞（LT） CD4 + /CD8 + 比值与认知障碍之间的关联。
开展了一项横断面研究，纳入207名年龄超过50岁的HIV感染成人，他们在墨西哥城的一家三级护理医院接受治疗。参与者接受了标准化的老年医学和神经心理学评估，以根据经过验证的安蒂诺里标准确定是否存在HIV相关神经认知障碍。采用多因素逻辑回归模型来确定T细胞CD4 + /CD8 + 淋巴细胞比值三分位数（0.57 - 0.91、<0.56；以>0.91作为参照类别）与认知障碍之间的关联。
参与者的年龄中位数为56岁（四分位间距53 - 62岁），男性有173人（83.6%）。根据安蒂诺里标准，任何类型认知障碍的患病率为66.2%（n = 137），其中比例最高的是无症状神经认知障碍（n = 114，83.2%）。校正后的逻辑回归分析显示，最低的LT-CD4 + /CD8 + 比值三分位数（<0.56）与认知障碍的存在独立相关（比值比3.16；95%置信区间1.22 - 8.16，p = 0.017）。
较低的LT-CD4 + /CD8 + 比值与HIV感染的认知障碍老年人独立相关，这是另一个可用于识别高危个体的因素，有助于关注认知筛查以及纠正其他可改变的危险因素。
