PLoS ONE (Jan 2019)

The dynamic association between Frailty, CD4 and CD4/CD8 ratio in people aging with HIV.

  • Giovanni Guaraldi,
  • Stefano Zona,
  • Ana Rita Silva,
  • Marianna Menozzi,
  • Giovanni Dolci,
  • Jovana Milic,
  • Federica Carli,
  • Cristina Mussini

DOI
https://doi.org/10.1371/journal.pone.0212283
Journal volume & issue
Vol. 14, no. 2
p. e0212283

Abstract

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ObjectiveTo investigate the association between current CD4+ T-cell count and CD4/CD8+ ratio with severity of frailty among people aging with HIV.MethodsCross-sectional observational study analysing data from all study visits in the ongoing prospective Modena HIV Metabolic Clinic Cohort between 2006 and 2015. Frailty severity was assessed using a frailty index (FI). We visualized the relationships between frailty index score and current CD4 cell count and CD4/CD8 ratio on two different curves adjusted for age, sex, and duration of HIV infection.ResultsFrailty index scores exhibited an inverse relationship with current CD4 count, up to 900 cells/μL. The CD4/CD8 ratio was inversely correlated with frailty index both below and above the cut-off of 900 CD4 cells/μL.ConclusionsFrailty in PLWH is inversely associated with both immune-activation, depicted by CD4/CD8 ratio and immune-deficit depicted by CD4 count. The first association shows a linear shape while the second shows a hook-shape with a turning point at 900 cells. Above this cut off level CD4 do not represent a significant risk factor for frailty.