Background: A low proportion of CD28-CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing BMI changes in the proportion of CD57+CD28-CD8+ T cells among HIV-infected individuals on ART is unknown.
Setting: In a U.S. cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28-CD57+CD8+ T cells, % CD57+ of CD28-CD8+ T cells and % CD28- of all CD8+ T cells.
Methods: Multivariable linear regression analysis was used to estimate beta-coefficients for each of three T cell phenotypes. Covariates included HIV parameters (current and nadir CD4, current viral load), demographics (age, race, income, study site), and lifestyle (tobacco, alcohol use) factors.
Results: Of 225 participants, the median age was 46 years and 50% were obese (BMI>30 m2/kg). Greater BMI and waist circumference were both associated with higher %CD28-CD57+CD8+ T cells and %CD57+ of all CD28-CD8+ T cells in multivariable analysis, including adjustment for HIV viral load (all p<0.05). The association between greater BMI and the overall proportion of CD28- CD8+ cells in fully adjusted models (0.078, 95% CI: (-0.053 - 0.209) were not significant.
Conclusions: In this analysis, greater BMI and waist circumference are associated with greater expression of CD57 on CD28-CD8+ T cells and a greater proportion of CD57+CD28- CD8+ T cells. These findings may indicate that increasing BMI is immunologically protective in HIV-infected women. Future research is needed to understand the prognostic importance of these associations on clinical outcomes.
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