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JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000001
Clinical Science

CD8 T-Cell Activation Is Associated With Lipodystrophy and Visceral Fat Accumulation in Antiretroviral Therapy–Treated Virologically Suppressed HIV-Infected Patients

Guaraldi, Giovanni MD*; Luzi, Kety MD; Bellistrì, Giusi Maria MD; Zona, Stefano MD*; Domingues da Silva, Ana Rita MD; Bai, Francesca MD; Garlassi, Elisa MD*; Marchetti, Giulia MD,PhD; Capeau, Jacqueline MD, PhD§; d’Arminio Monforte, Antonella MD

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Abstract

Objective: HIV-infected patients receiving antiretroviral treatment frequently accumulate fat at the abdominal level. It is unknown whether T-cell activation and immune phenotypes are associated with fat accumulation. Thus, the aim of the study was to search for an association between the presence of clinical lipodystrophy (LD), visceral and subcutaneous abdominal adipose tissue amount (VAT and SAT), and peripheral T-cell immune phenotypes.

Design: Cross-sectional study including 87 HIV-infected antiretroviral therapy–treated virologically suppressed and immune-reconstituted patients.

Methods: The patients were evaluated for clinical LD, VAT, SAT, homeostasis model of insulin resistance, and coronary artery calcium score (>10). T-cell activation (CD8/CD38), differentiation (CD4/CD8/CCR7/CD45RA), and expression/activation of the interleukin-7 (IL-7)/IL-7R system (CD4/CD8/CD127, IL-7, and CD4/CD8/pStat-5) were assessed by cytometry.

Results: In multivariable analyses, CD8+ T-cell activation (CD38+) was associated with lipoatrophy and central fat accumulation (respectively, β = 5.63, P = 0.005, and β = 4.19, P = 0.020). This was also the case for IL-7R expressing CD8+ T cells (CD127+) for lipoatrophy β = 12.8, P = 0.003, and for central fat accumulation β = 9.45, P = 0.016. CD8+ T-cell activation was also associated with VAT/total adipose tissue (β = 0.01, P = 0.002) and SAT/VAT ratios (β = −0.014, P = 0.015). As expected, VAT/total adipose tissue was an independent risk factor for homeostasis model of insulin resistance (r = 0.364, P = 0.028) and cardiovascular risk (coronary artery calcium, r = 0.406, P = 0.002).

Conclusions: CD8+ T-cell activation was associated with LD and the relative amount of VAT in antiretroviral therapy–controlled, virologically suppressed, HIV-infected patients. We propose that CD8 activation may be involved in the accumulation of central fat frequently observed in these patients, with resulting increased cardiometabolic risk.

© 2013 by Lippincott Williams & Wilkins

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