HIV-Infected Individuals with Low CD4/CD8 Ratio despite Effective Antiretroviral Therapy Exhibit Altered T Cell Subsets, Heightened CD8+ T Cell Activation, and Increased Risk of Non-AIDS Morbidity and Mortality
Figure 5
Impact of early or later ART initiation in peripheral CD4+ T cell counts, CD8+ T cell counts and CD4/CD8 ratio in the OPTIONS cohort.
The CD4/CD8 ratio was compared between HIV-uninfected individuals (blue) and HIV-infected individuals initiating ART “early,” ≤6 months of infection (green), or “later,” ≥2 years after initial infection (red), at acute HIV diagnosis and after 1 year of ART. Median CD4/CD8 ratio was significantly higher after one year in early ART initiators compared to later initiators. (A). Early ART initiators experienced higher CD4+ T cell increase (B) than later initiators (C) after one year of ART (221 cells/mm3 vs. 130, respectively, P<0.001). No differences were observed in CD8+ T cell counts between early (D) and later ART initiators (E) after one year of ART (−212 cells/mm3 vs. −114, respectively, P = 0.098) but CD8+ T cells were significantly different between groups beyond one year of ART (−309 cells/mm3 vs. −114, respectively, P = 0.014). Changes in the CD4/CD8 ratio among recently HIV-infected individuals initiating ART early (F) and later (G) were also assessed over time. Early ART initiators experienced a higher increase at one year of ART than later initiators (+0.43 vs. +0.25, P<0.001). Individual participant trajectories shown with red lines, estimated mean values over time from linear mixed models adjusted by age, sex, baseline CD4+ T cells shown in thick black lines.