The dynamic association between Frailty, CD4 and CD4/CD8 ratio in people aging with HIV.

Giovanni Guaraldi,Stefano Zona,Giovanni Dolci,Cristina Mussini,Federica Carli,Jovana Milic,Marianna Menozzi,Ana Rita Silva,Graciela Andrei

doi:10.1371/journal.pone.0212283

Giovanni Guaraldi, Stefano Zona + Show 7 more

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https://doi.org/10.1371/journal.pone.0212283

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Abstract

ObjectiveTo investigate the association between current CD4+ T-cell count and CD4/CD8+ ratio with severity of frailty among people aging with HIV.MethodsCross-sectional observational study analysing data from all study visits in the ongoing prospective Modena HIV Metabolic Clinic Cohort between 2006 and 2015. Frailty severity was assessed using a frailty index (FI). We visualized the relationships between frailty index score and current CD4 cell count and CD4/CD8 ratio on two different curves adjusted for age, sex, and duration of HIV infection.ResultsFrailty index scores exhibited an inverse relationship with current CD4 count, up to 900 cells/μL. The CD4/CD8 ratio was inversely correlated with frailty index both below and above the cut-off of 900 CD4 cells/μL.ConclusionsFrailty in PLWH is inversely associated with both immune-activation, depicted by CD4/CD8 ratio and immune-deficit depicted by CD4 count. The first association shows a linear shape while the second shows a hook-shape with a turning point at 900 cells. Above this cut off level CD4 do not represent a significant risk factor for frailty.

Highlights

Aging is associated with an increased risk of several adverse health outcomes, including illnesses, disabilities and death
The CD4/CD8 ratio was inversely correlated with frailty index both below and above the cut-off of 900 CD4 cells/μL
Frailty in people living with HIV (PLWH) is inversely associated with both immune-activation, depicted by CD4/CD8 ratio and immune-deficit depicted by CD4 count

Summary

Objective

To investigate the association between current CD4+ T-cell count and CD4/CD8+ ratio with severity of frailty among people aging with HIV. Editor: Graciela Andrei, Katholieke Universiteit Leuven Rega Institute for Medical Research, BELGIUM. Data Availability Statement: All relevant data are within the paper and its Supporting Information files.

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