2155. Prediction of liver disease, AIDS and mortality based on discordant absolute and relative peripheral CD4 T lymphocytes in HIV/HCV co-infected individuals
Session: Poster Abstract Session: HIV/HCV Coinfection and Liver Disease
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • Poster_2.pdf (717.6 kB)
  • Background:Hepatitis C virus (HCV) induced liver fibrosis and splenomegaly may lead to discordance between absolute numbers and percentages of lymphocytes and subpopulations because of sequestration. Here we investigated lymphocyte discordance in HIV/HCV co-infected individuals and its relationship to progression to liver disease, AIDS and all-cause mortality.

    Methods:Observational prospective cohort study. Adjusted hazard ratios (aHR) with 95% confidence intervals (95% CI) associated with liver disease, AIDS or mortality were computed by time-updated Cox proportional hazards regression.

    Results: Of 380 HIV/HCV coinfected individuals followed for a median of 8.2 years, 360 individuals had a median of 11 discordant measurements corresponding to 5080 of 9091 paired samples (56%). By multivariate analysis, a doubling of absolute or percentage CD4 T lymphocytes was associated with a comparable lower risk of mortality [aHR: 0.63, (0.56-0.72), P <.0001 and aHR: 0.65 (0.54-0.78), P <.0001], respectively]. Higher CD4:CD8-ratio was associated with a lower mortality risk [aHR: 0.40, CI: 0.22-0.72 per doubling, P=0.003]. Only absolute CD4 T lymphocyte measurements predicted AIDS ((aHR: 0.73, (0.56-0.96, per doubling P=0.03) or CD4 count <200 compared to 200-500 per µl [aHR: 2.72 (1.13-6.52), P: 0.03]). Neither CD4 nor CD8 percentage was associated with risk of AIDS. Higher absolute lymphocyte count was associated with a lower risk of AIDS (aHR: 0.60 (0.37-0.96), P= 0.03) and of death [aHR: 0.66 (0.53-0.82), P= 0.0002]. Neither total lymphocyte count nor any subpopulations predicted the development of liver disease.

    Conclusion: Despite a high prevalence of discordance with HIV/HCV coinfection, both absolute CD4 T lymphocyte count and percentage predicted mortality, whereas only absolute CD4 T lymphocyte count predicted the development of AIDS. Further, total lymphocyte count was associated with risk of AIDS and death. Neither absolute nor percentage CD4, CD8 T or total lymphocytes predicted the development of liver disease in this cohort.

    Sandra Skrumsager Hansen, BM, Gitte Kronborg, MD, DMSc and Thomas Benfield, MD, DMSc, Department of Infectious Disease, Hvidovre University Hospital, Hvidovre, Denmark

    Disclosures:

    S. S. Hansen, None

    G. Kronborg, None

    T. Benfield, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.