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.
S. S. Hansen,
T. Benfield, None