CD8 T-cell expansion and inflammation linked to CMV coinfection in ART-treated HIV infection

ML Freeman, JC Mudd, CL Shive… - Clinical Infectious …, 2016 - academic.oup.com
ML Freeman, JC Mudd, CL Shive, SA Younes, S Panigrahi, SF Sieg, SA Lee, PW Hunt
Clinical Infectious Diseases, 2016academic.oup.com
Abstract Background. Persistent CD8 T-cell expansion, low CD4/CD8 T-cell ratios, and
heightened inflammation persist in antiretroviral therapy (ART)-treated human
immunodeficiency virus (HIV) infection and are associated with increased risk of morbid
outcomes. We explored the role of cytomegalovirus (CMV) infection in CD8 lymphocytosis
and inflammation in ART-treated HIV infection. Methods. Absolute CD4 and CD8 T-cell
counts were abstracted from clinical records and compared among 32 HIV-infected CMV …
Abstract
Background.  Persistent CD8 T-cell expansion, low CD4/CD8 T-cell ratios, and heightened inflammation persist in antiretroviral therapy (ART)-treated human immunodeficiency virus (HIV) infection and are associated with increased risk of morbid outcomes. We explored the role of cytomegalovirus (CMV) infection in CD8 lymphocytosis and inflammation in ART-treated HIV infection.
Methods.  Absolute CD4 and CD8 T-cell counts were abstracted from clinical records and compared among 32 HIV-infected CMV-seronegative subjects, 126 age, CD4 and gender-matched HIV-infected CMV-seropositive subjects, and among 21 HIV-uninfected controls (9 CMV-negative, 12 CMV-positive). Plasma inflammatory indices were measured in a subset by ELISA.
Results.  Median CD8 counts/µL were higher in HIV-positive/CMV-positive patients (795) than in HIV-positive/CMV-negative subjects (522, P = .006) or in healthy controls (451, P = .0007), whereas CD8 T-cell counts were similar to controls' levels in HIV-positive/CMV-negative subjects. Higher plasma levels of IP-10 (P = .0011), TNF-RII (P = .0002), and D-dimer (P = .0444) were also found in coinfected patients than in HIV-positive/CMV-negative subjects.
Conclusions.  CMV infection is associated with higher CD8 T-cell counts, resultant lower CD4/CD8 ratios, and increased systemic inflammation in ART-treated HIV infection. CMV infection may contribute to risk for morbid outcomes in treated HIV infection.
Oxford University Press