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Higher Body Mass Index is Associated with Greater Proportions of Effector CD8+ T cells Expressing CD57 in Women Living with HIV.

Reid, Michael J. A. MD, MPH; Baxi, Sanjiv M. MD, PhD, MPH; Sheira, Lila A. MPH; Landay, Alan L. PhD; Frongillo, Edward A. PhD; Adedimeji, Adebola PhD; Cohen, Mardge H. MD; Wentz, Eryka MA; Gustafson, Deborah R PhD; Merenstein, Daniel MD; Hunt, Peter W. MD; Tien, Phyllis C. MD; Weiser, Sheri D. MD, MA, MPH; for the Womens Interagency HIV Study (WIHS)
JAIDS Journal of Acquired Immune Deficiency Syndromes: Post Acceptance: March 20, 2017
doi: 10.1097/QAI.0000000000001376
Original Article: PDF Only

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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