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Castilho, Jessica L; Bian, Aihua; Jenkins, Cathy A; Shepherd, Bryan E; Sigel, Keith; Gill, M John; Kitahata, Mari M; Silverberg, Michael J; Mayor, Angel M; Coburn, Sally B; Wiley, Dorothy; Achenbach, Chad J; Marconi, Vincent C; Bosch, Ronald J; Horberg, Michael A; Rabkin, Charles S; Napravnik, Sonia; Novak, Richard M; Mathews, W Christopher; Thorne, Jennifer E; Sun, Jing; Althoff, Keri N; Moore, Richard D; Sterling, Timothy R; [...]

CD4/CD8 Ratio and Cancer Risk Among Adults With HIV

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  • Medientyp: E-Artikel
  • Titel: CD4/CD8 Ratio and Cancer Risk Among Adults With HIV
  • Beteiligte: Castilho, Jessica L; Bian, Aihua; Jenkins, Cathy A; Shepherd, Bryan E; Sigel, Keith; Gill, M John; Kitahata, Mari M; Silverberg, Michael J; Mayor, Angel M; Coburn, Sally B; Wiley, Dorothy; Achenbach, Chad J; Marconi, Vincent C; Bosch, Ronald J; Horberg, Michael A; Rabkin, Charles S; Napravnik, Sonia; Novak, Richard M; Mathews, W Christopher; Thorne, Jennifer E; Sun, Jing; Althoff, Keri N; Moore, Richard D; Sterling, Timothy R; [...]
  • Erschienen: Oxford University Press (OUP), 2022
  • Erschienen in: JNCI: Journal of the National Cancer Institute
  • Sprache: Englisch
  • DOI: 10.1093/jnci/djac053
  • ISSN: 0027-8874; 1460-2105
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Independent of CD4 cell count, a low CD4/CD8 ratio in people with HIV (PWH) is associated with deleterious immune senescence, activation, and inflammation, which may contribute to carcinogenesis and excess cancer risk. We examined whether low CD4/CD8 ratios predicted cancer among PWH in the United States and Canada.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We examined all cancer-free PWH with 1 or more CD4/CD8 values from North American AIDS Cohort Collaboration on Research and Design observational cohorts with validated cancer diagnoses between 1998 and 2016. We evaluated the association between time-lagged CD4/CD8 ratio and risk of specific cancers in multivariable, time-updated Cox proportional hazard models using restricted cubic spines. Models were adjusted for age, sex, race and ethnicity, hepatitis C virus, and time-updated CD4 cell count, HIV RNA, and history of AIDS-defining illness.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Among 83 893 PWH, there were 5628 incident cancers, including lung cancer (n = 755), Kaposi sarcoma (n = 501), non-Hodgkin lymphoma (n = 497), and anal cancer (n = 439). The median age at cohort entry was 43 years. The overall median 6-month lagged CD4/CD8 ratio was 0.52 (interquartile range = 0.30-0.82). Compared with a 6-month lagged CD4/CD8 of 0.80, a CD4/CD8 of 0.30 was associated with increased risk of any incident cancer (adjusted hazard ratio = 1.24 [95% confidence interval = 1.14 to 1.35]). The CD4/CD8 ratio was also inversely associated with non-Hodgkin lymphoma, Kaposi sarcoma, lung cancer, anal cancer, and colorectal cancer in adjusted analyses (all 2-sided P &amp;lt; .05). Results were similar using 12-, 18-, and 24-month lagged CD4/CD8 values.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A low CD4/CD8 ratio up to 24 months before cancer diagnosis was independently associated with increased cancer risk in PWH and may serve as a clinical biomarker. </jats:p> </jats:sec>
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