Full
Outline
To analyze the dynamic trajectory of the CD4/CD8 ratio and its influencing factors in human immunodeficiency virus (HIV)-infected patients after initiating antiretroviral therapy (ART), and to explore its association with risk of mortality.
Data were obtained from HIV-infected patients who initiated ART between 2005 and 2023 in Wuxi.A latent class trajectory model was adopted to identify distinct trajectories of CD4/CD8 ratio. A multivariable logistic regression model was applied to analyze the factors influencing the trajectories of CD4/CD8 ratio, while a generalized linear mixed model tree (GLMMT) was employed to explore population characteristics associated with trajectory group membership. Furthermore,the Cox proportional hazards regression model was used to assess the association between trajectories and mortality.
A total of 3 808 HIV-infected patients were included. Two distinct trajectories of CD4/CD8 ratio were identified: a gradual recovery group(28.02%, 1 067/3 808) and a sustained inversion group(71.98%, 2 741/3 808). Multivariable logistic regression analysis revealed that patients who were male(OR=1.29, 95% CI: 1.01-1.64), infected through homosexual contact (OR=1.25,95% CI: 1.04-1.49), initiated ART more than 30 days after diagnosis (OR=1.70, 95% CI: 1.47-1.97), had baseline CD4 count <200 cells/μl (OR=1.21, 95% CI: 1.03-1.43), and had baseline CD4/CD8 ratio <1 (OR=2.24, 95% CI: 1.59-3.17) were more likely to belong to the sustained inversion group. GLMMT analysis showed that the prevalence of sustained CD4/CD8 ratio inversion was 77.72% (1 427/1 836) among HIV-infected individuals with ART initiation >30 days and a baseline CD4/CD8 ratio <1, and 73.85% (401/543) among those with ART initiation ≤30 days who were male and had a baseline CD4 count <200 cells/μl. Furthermore, individuals in the sustained inversion group had a significantly increased risk of acquired immunodeficiency syndrome (AIDS)-related death (HR=4.90, 95% CI: 1.52-15.83), but no significant association was found with non-AIDS-related death.
The persistent inversion of the CD4/CD8 ratio is common among people living with HIV. A comprehensive assessment of immune status and disease progression should, therefore, include not only the CD4 count but also the CD4/CD8 ratio, while fully considering the influence of demographic and behavioral factors.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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