Background: HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy.
Methods: 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study.
Results: After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p < 0.05) and had the largest effect on development of MetS (Wald = 9.01; OR = 0.45), followed by cART (Wald = 7.87; OR = 0.10) and triglycerides (Wald = 5.27; OR = 1.7). On the other hand, body weight and waist circumference showed no statistically significant effect on the development of MetS after six months of cART, p > 0.05.
Conclusions: CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients.
Uvod: HIV-infekcija se karakteriše progresivnim gubitkom CD4+ T-ćelija zbog njihove smanjene sinteze, povećanog uništavanja i izrazite aktivacije i ekspanzije CD8+ T limfocita. Količnik CD4/CD8 je tradicionalno opisivan kao marker imunostarenja u opštoj populaciji, ali se sve više pojavljuje kao marker različitih ishoda kod HIV-inficiranih pojedinaca. Osnovni cilj istraživanja je da se ispita kolika je moć CD4/CD8 količnika da predvidi nastanak metaboličkog sindroma kod HIV pozitivnih pacijenata koji primaju cART terapiju.
Metode: U retrospektivnoj studiji slučaj/kontrola je bilo uključeno 80 HIV/AIDS ispitanika. Za određivanje udela (procenta) CD4+ i CD8+ ćelija iz periferne krvi pacijenata, korišćena je metoda protočne citometrije. U ovoj studiji evaluirane su vrednosti biohemijskih parametara (trigliceridi, HDL, šećer u krvi, KS), imunoloških parametara (CD4/CD8, PCR), antropometrijska merenja, te vrsta cART.
Rezultati: Nakon 6 meseci cART terapije 19 (23,8%) ispitanika je ispunjavalo sve kriterijume za postavljanje dijagnoze MS. Multivarijantnom analizom statistički značajan (p < 0,05) i najveći uticajan na razvoj MS je imao količnik CD4/CD8 (Wald = 9,01; OR = 0,45), potom cART (Wald = 7,87; OR = 0,10), i na kraju trigliceridi (Wald = 5,27; OR = 1,7). S druge strane, telesna težina i obim struka nisu pokazali statistički značajan uticaj na razvoj MS nakon {est meseci cART, p > 0,05.
Zaključak: Količnik CD4/CD8 se pokazao se kao značajan marker u predikciji metaboličkog sindroma kod HIV/AIDS pacijenata.
Keywords: CD4/CD8 ratio; HIV/AIDS; cART; metabolic syndrome.