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

Background. 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) in...

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Bibliographic Details
Published in:Clinical infectious diseases 2016-02, Vol.62 (3), p.392-396
Main Authors: 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.
Format: Article
Language:English
Subjects:
Adult
Anti-Retroviral Agents - therapeutic use
Antiretroviral drugs
CD4-CD8 Ratio
CD4-Positive T-Lymphocytes - immunology
CD8-Positive T-Lymphocytes - immunology
Cohort Studies
Coinfection - pathology
Cytokines - blood
Cytomegalovirus
Cytomegalovirus Infections - pathology
Enzyme-Linked Immunosorbent Assay
Female
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - pathology
HIV/AIDS
Human immunodeficiency virus
Humans
Inflammation
Lymphocyte Count
Lymphocytosis - pathology
Male
Middle Aged
Plasma - chemistry
T cell receptors
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Summary:Background. 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. Methods. 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. Results. 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. Conclusions. 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.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/civ840