CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies - Archive ouverte HAL
Article Dans Une Revue Clinical Infectious Diseases Année : 2021

CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies

1 Centre Hospitalier Victor Dupouy
2 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
3 Hôpital Hôtel-Dieu [Paris]
4 Imperial College London
5 UB - Universitat de Barcelona
6 ULB - Université libre de Bruxelles
7 CHU Montpellier = Montpellier University Hospital
8 BPH - Bordeaux population health
9 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
10 UvA - University of Amsterdam [Amsterdam] = Universiteit van Amsterdam
11 UNIMORE - Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia
12 SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
13 Hôpitaux Sud - Hôpital Sainte-Marguerite [CHU - APHM]
14 PMU - Paracelsus Medizinische Privatuniversität = Paracelsus Medical University
15 Evangelismos Athens General Hospital
16 CESP - Centre de recherche en épidémiologie et santé des populations
17 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
18 RKI - Robert Koch Institute [Berlin]
19 University Hospital Bonn
20 National Institute for Infectious Diseases "Lazzaro Spallanzani"
21 UniBs - Università degli Studi di Brescia = University of Brescia
22 INSERM U1219 - UB - ISPED - Team MORPH3EUS
23 UCPH - University of Copenhagen = Københavns Universitet
24 IRCCS Ospedale San Raffaele [Milan, Italy]
25 Inselspital - Bern University Hospital [Berne]
26 Karolinska Institutet [Stockholm]
27 Public Health England [London]
28 Hôpital Cochin [AP-HP]

Résumé

BACKGROUND: A persistently low CD4/CD8 ratio has been reported to inversely correlate with the risk of non-AIDS defining cancer in people living with human immunodeficiency virus (HIV; PLWH) efficiently treated by combination antiretroviral therapy (cART). We evaluated the impact of the CD4/CD8 ratio on the risk of Kaposi sarcoma (KS) or non-Hodgkin lymphoma (NHL), still among the most frequent cancers in treated PLWH. METHODS: PLWH from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) were included if they achieved virological control (viral load ≤ 500 copies/mL) within 9 months following cART and without previous KS/LNH diagnosis. Cox models were used to identify factors associated with KS or NHL risk, in all participants and those with CD4 ≥ 500/mm3 at virological control. We analyzed the CD4/CD8 ratio, CD4 count and CD8 count as time-dependent variables, using spline transformations. RESULTS: We included 56 708 PLWH, enrolled between 2000 and 2014. At virological control, the median (interquartile range [IQR]) CD4 count, CD8 count, and CD4/CD8 ratio were 414 (296-552)/mm3, 936 (670-1304)/mm3, and 0.43 (0.28-0.65), respectively. Overall, 221 KS and 187 NHL were diagnosed 9 (2-37) and 18 (7-42) months after virological control. Low CD4/CD8 ratios were associated with KS risk (hazard ratio [HR] = 2.02 [95% confidence interval {CI } = 1.23-3.31]) when comparing CD4/CD8 = 0.3 to CD4/CD8 = 1) but not with NHL risk. High CD8 counts were associated with higher NHL risk (HR = 3.14 [95% CI = 1.58-6.22]) when comparing CD8 = 3000/mm3 to CD8 = 1000/mm3). Similar results with increased associations were found in PLWH with CD4 ≥ 500/mm3 at virological control (HR = 3.27 [95% CI = 1.60-6.56] for KS; HR = 5.28 [95% CI = 2.17-12.83] for NHL). CONCLUSIONS: Low CD4/CD8 ratios and high CD8 counts despite effective cART were associated with increased KS/NHL risks respectively, especially when CD4 ≥ 500/mm3.

Dates et versions

hal-03358925 , version 1 (29-09-2021)

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Citer

Fabienne Caby, Marguerite Guiguet, Laurence Weiss, Alan Winston, Jose M. Miro, et al.. CD4/CD8 Ratio and the Risk of Kaposi Sarcoma or Non-Hodgkin Lymphoma in the Context of Efficiently Treated Human Immunodeficiency Virus (HIV) Infection: A Collaborative Analysis of 20 European Cohort Studies. Clinical Infectious Diseases, 2021, 73 (1), pp.50-59. ⟨10.1093/cid/ciaa1137⟩. ⟨hal-03358925⟩
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