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CD8 T-Cell Expansion and Inflammation Linked to CMV Coinfection in ART-treated HIV Infection.

  • Author(s): Freeman, Michael L
  • Mudd, Joseph C
  • Shive, Carey L
  • Younes, Souheil-Antoine
  • Panigrahi, Soumya
  • Sieg, Scott F
  • Lee, Sulggi A
  • Hunt, Peter W
  • Calabrese, Leonard H
  • Gianella, Sara
  • Rodriguez, Benigno
  • Lederman, Michael M
  • et al.

Published Web Location

https://academic.oup.com/cid/article/62/3/392/2462670
No data is associated with this publication.
Abstract

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.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.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.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.

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