Skip Navigation LinksHome > October 1, 2014 - Volume 67 - Issue 2 > Factors Associated With CD8+ T-Cell Activation in HIV-1–Infe...
JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0000000000000286
Clinical Science

Factors Associated With CD8+ T-Cell Activation in HIV-1–Infected Patients on Long-term Antiretroviral Therapy

Zheng, Lu PhD*; Taiwo, Babafemi MBBS; Gandhi, Rajesh T. MD‡,§; Hunt, Peter W. MD; Collier, Ann C. MD; Flexner, Charles MD#; Bosch, Ronald J. PhD**

Collapse Box


Background: Abnormal levels of CD8+ T-cell activation persist in HIV-1–infected patients on suppressive antiretroviral therapy (ART) and may be deleterious.

Methods: CD8+ T-cell activation (% coexpressing CD38/HLA-DR) was analyzed on blood specimens from 833 HIV-1–infected patients on ART for ≥96 weeks with concurrent plasma HIV RNA (vRNA) ≤200 copies per milliliter. Factors associated with CD8+ T-cell activation were assessed using generalized estimating equations to incorporate longitudinal measurements (median 4/participant).

Results: Participants were 84% men, 47% white, 28% black, and 22% Hispanic, with median pre-ART age 38 years and median ART exposure 144 weeks. CD8+ T-cell activation was higher at timepoints when vRNA was 51–200 versus ≤50 copies per milliliter [mean CD8+ T-cell activation 23.4% vs. 19.7%; adjusted difference: 1.7% (95% confidence interval: 0.1 to 3.4), P = 0.042]. Restricting to vRNA ≤50 copies per milliliter, multivariable models showed the following factors associated with higher CD8+ T-cell activation: older age [≥45 vs. ≤30 years: 3.6% (1.4 to 5.7), P = 0.004], hepatitis C virus antibody positivity [3.6% (0.9 to 6.2), P = 0.032], Hispanic vs. white [7.2% (5.3 to 9.0), P < 0.001], lower concurrent CD4 count [≤200 vs. >500 cells/mm3: 2.2% (0.7 to 3.7), P < 0.001], lower concurrent CD4/CD8 ratio [−2.6% (−3.7 to −1.5) per 0.5 unit increase, P < 0.001], and higher pre-ART CD8+ T-cell activation [2.0% (1.6 to 2.5) per 10% higher, P < 0.001].

Conclusions: In participants included in our analysis, residual low-level viremia between 51 and 200 copies per milliliter during ART was shown to be associated with greater CD8+ T-cell activation than full suppression to <50 copies per milliliter. Older age, hepatitis C virus antibody positivity, race/ethnicity, higher pre-ART CD8+ T-cell activation, and lower concurrent CD4/CD8 ratio and CD4+ T-cell count also contribute to greater CD8+ T-cell activation during suppressive ART.

© 2014 by Lippincott Williams & Wilkins


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.