A higher CD4/CD8 ratio correlates with an ultralow cell-associated HIV-1 DNA level in chronically infected patients on antiretroviral therapy: a case control study

BMC Infect Dis. 2017 Dec 15;17(1):771. doi: 10.1186/s12879-017-2866-y.

Abstract

Background: The HIV-1 DNA reservoir is an important marker that reflects viro-immunological status and can be affected by multiple viral or cellular factors. Determining the potential factors associated with the size of the HIV-1 DNA reservoir benefits the surveillance of disease progression and antiretroviral treatments.

Methods: We conducted a case control study to explore the factors that may affect the level of HIV-1 DNA. The level of HIV-1 total DNA in peripheral blood at 5 time points was quantified by quantitative PCR. Chronically HIV-1-infected patients whose cell-associated HIV-1 DNA levels were below the detection limit after receiving antiretroviral therapy (ART) for 96 weeks were identified (group 1), and patients who still had detectable levels of cell-associated HIV-1 DNA after ATR treatment were used as the control (group 2).

Results: Twenty-one patients with ultralow levels of cell-associated HIV-1 DNA [<20 copies/106 peripheral blood mononuclear cells (PBMCs)] presented with a lower CD8+ T-cell count (average: 511 ± 191 versus 715 ± 256 cells/μL, p = 0.013) and a higher CD4/CD8 ratio (average: 1.04 ± 0.37 versus 0.72 ± 0.32, respectively, p = 0.002) at week 96. In the multivariate analysis, patients with a higher CD4/CD8 ratio at week 96 were more likely to have levels of HIV-1 DNA below the detection limit (per 0.1 increase, OR = 1.29, 95% CI, 1.05-1.59, p = 0.017).

Conclusion: After matching baseline HIV-1 DNA levels, a higher CD4/CD8 ratio at week 96 was the only factor associated with an ultralow level of HIV-1 DNA. The CD4/CD8 ratio can be used as an easy biomarker to help monitor patients on ART who will be selected to participate in eradication studies.

Keywords: Antiretroviral therapy; CD4/CD8 ratio; CD8+ T-lymphocytes; DNA reservoir; HIV-1.

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • CD4-CD8 Ratio
  • CD4-Positive T-Lymphocytes / cytology
  • CD8-Positive T-Lymphocytes / cytology
  • Case-Control Studies
  • Chronic Disease
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • HIV-1 / genetics*
  • HIV-1 / isolation & purification
  • Humans
  • Leukocytes, Mononuclear / cytology
  • Limit of Detection
  • Male
  • Multivariate Analysis
  • RNA, Viral / blood*
  • Real-Time Polymerase Chain Reaction
  • Viral Load

Substances

  • Anti-Retroviral Agents
  • RNA, Viral