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Inicio Medicina Clínica (English Edition) Aging and influence of inversion of the CD4:CD8 ratio in the incidence of co-mor...
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Vol. 146. Issue 5.
Pages 189-193 (March 2016)
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Vol. 146. Issue 5.
Pages 189-193 (March 2016)
Original article
Aging and influence of inversion of the CD4:CD8 ratio in the incidence of co-morbidities and mortality in a cohort of patients infected with human immunodeficiency virus
Envejecimiento e influencia de la inversión del cociente CD4/CD8 en la incidencia de las comorbilidades y mortalidad de una cohorte de pacientes infectados por el virus de inmunodeficiencia humana
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Miguel Cervero
Corresponding author
mcerveroj@gmail.com

Corresponding author.
, Rafael Torres, Jose Luis Agud, Susana Pastor, Juan José Jusdado
Departamento de Medicina Interna, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
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Table 1. Baseline characteristics and treatment in cohort participants.
Table 2. Incidence rate of clinical events.
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Abstract
Background and objective

It has been postulated that the inversion of the CD4:CD8 ratio as a hallmark of immunosenescence can be an independent factor that can herald the risk of co-morbidities. We studied the influence of aging and inversion of the CD4:CD8 ratio in the incidence of comorbidities and mortality in the cohort of Hosptital Severo Ochoa.

Methods

We analyzed the differences in the incidence rates of age-adjusted morbidities and evaluated the inversion of the CD4:CD8 ratio as predictor of mortality and development of comorbidities.

Results

Age was associated with an increased incidence rate of diabetes mellitus, fractures, COPD and non-AIDS malignancies. We found an increased incidence rate of non-AIDS clinical events (OR 2.25; 95% CI 1.025–4.94) and AIDS events (OR 3.48; 95% CI 1.58–7.64) in individuals with CD4:CD8 ratio <0.7. Moreover, patients with a CD4:CD8 ratio <0.7 ratio had a higher risk of mortality (OR 5.96; 95% CI 0.73–48.40).

Conclusion

It is important to detect and prevent non-AIDS comorbidities in the presence of a CD4:CD8 ratio <0.7.

Keywords:
CD4:CD8 ratio
Human immunodeficiency virus
Premature aging
Morbidity
Resumen
Fundamentos y objetivo

La inversión del cociente CD4/CD8 como indicador de inmunosenescencia puede ser un factor que permita anunciar el riesgo de presentar comorbilidades. Estudiamos la influencia del envejecimiento y de la inversión del cociente CD4/CD8 en la incidencia de comorbilidades y de mortalidad en la cohorte del Hospital Severo Ochoa.

Métodos

Analizamos las diferencias en las tasas de incidencia de las comorbilidades ajustadas por la edad y evaluamos la inversión del cociente CD4/CD8 como factor de riesgo para la mortalidad y para el desarrollo de comorbilidades.

Resultados

La edad se asoció a un incremento en la tasa de incidencia de diabetes mellitus, fracturas, EPOC y neoplasias no asociadas a sida. Encontramos un mayor riesgo de la tasa de incidencia de episodios clínicos no asociados a sida (OR 2,25; IC 95% 1,025-4,94) y episodios asociados a sida (OR 3,48; IC 95% 1,58-7,64) en los individuos con el cociente CD4/CD8<0.7. También los pacientes con un cociente CD4/CD8<0,7 presentaron una mayor riesgo de mortalidad (OR 5,96; IC 95% 0,73-48,40).

Conclusión

Es importante detectar y prevenir comorbilidades no asociadas a sida en presencia del cociente CD4/CD8<0,7.

Palabras clave:
Cociente CD4/CD8
Virus de inmunodeficiencia humana
Envejecimiento prematuro
Morbilidad

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