CD4/CD8 Ratio and Cancer Risk Among Adults With HIV
© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissionsoup.com..
BACKGROUND: Independent of CD4 cell count, a low CD4/CD8 ratio in people with HIV (PWH) is associated with deleterious immune senescence, activation, and inflammation, which may contribute to carcinogenesis and excess cancer risk. We examined whether low CD4/CD8 ratios predicted cancer among PWH in the United States and Canada.
METHODS: We examined all cancer-free PWH with 1 or more CD4/CD8 values from North American AIDS Cohort Collaboration on Research and Design observational cohorts with validated cancer diagnoses between 1998 and 2016. We evaluated the association between time-lagged CD4/CD8 ratio and risk of specific cancers in multivariable, time-updated Cox proportional hazard models using restricted cubic spines. Models were adjusted for age, sex, race and ethnicity, hepatitis C virus, and time-updated CD4 cell count, HIV RNA, and history of AIDS-defining illness.
RESULTS: Among 83 893 PWH, there were 5628 incident cancers, including lung cancer (n = 755), Kaposi sarcoma (n = 501), non-Hodgkin lymphoma (n = 497), and anal cancer (n = 439). The median age at cohort entry was 43 years. The overall median 6-month lagged CD4/CD8 ratio was 0.52 (interquartile range = 0.30-0.82). Compared with a 6-month lagged CD4/CD8 of 0.80, a CD4/CD8 of 0.30 was associated with increased risk of any incident cancer (adjusted hazard ratio = 1.24 [95% confidence interval = 1.14 to 1.35]). The CD4/CD8 ratio was also inversely associated with non-Hodgkin lymphoma, Kaposi sarcoma, lung cancer, anal cancer, and colorectal cancer in adjusted analyses (all 2-sided P < .05). Results were similar using 12-, 18-, and 24-month lagged CD4/CD8 values.
CONCLUSIONS: A low CD4/CD8 ratio up to 24 months before cancer diagnosis was independently associated with increased cancer risk in PWH and may serve as a clinical biomarker.
| Errataetall: |
CommentIn: J Natl Cancer Inst. 2022 Jun 13;114(6):790-791. - PMID 35292810 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:114 |
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| Enthalten in: |
Journal of the National Cancer Institute - 114(2022), 6 vom: 13. Juni, Seite 854-862 |
| Sprache: |
Englisch |
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| Links: |
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Journal Article |
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| Anmerkungen: |
Date Completed 15.06.2022 Date Revised 29.03.2023 published: Print CommentIn: J Natl Cancer Inst. 2022 Jun 13;114(6):790-791. - PMID 35292810 Citation Status MEDLINE |
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| doi: |
10.1093/jnci/djac053 |
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| Förderinstitution / Projekttitel: |
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NLM338234993 |
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| 100 | 1 | |a Castilho, Jessica L |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a CD4/CD8 Ratio and Cancer Risk Among Adults With HIV |
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| 500 | |a Date Completed 15.06.2022 | ||
| 500 | |a Date Revised 29.03.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: J Natl Cancer Inst. 2022 Jun 13;114(6):790-791. - PMID 35292810 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Independent of CD4 cell count, a low CD4/CD8 ratio in people with HIV (PWH) is associated with deleterious immune senescence, activation, and inflammation, which may contribute to carcinogenesis and excess cancer risk. We examined whether low CD4/CD8 ratios predicted cancer among PWH in the United States and Canada | ||
| 520 | |a METHODS: We examined all cancer-free PWH with 1 or more CD4/CD8 values from North American AIDS Cohort Collaboration on Research and Design observational cohorts with validated cancer diagnoses between 1998 and 2016. We evaluated the association between time-lagged CD4/CD8 ratio and risk of specific cancers in multivariable, time-updated Cox proportional hazard models using restricted cubic spines. Models were adjusted for age, sex, race and ethnicity, hepatitis C virus, and time-updated CD4 cell count, HIV RNA, and history of AIDS-defining illness | ||
| 520 | |a RESULTS: Among 83 893 PWH, there were 5628 incident cancers, including lung cancer (n = 755), Kaposi sarcoma (n = 501), non-Hodgkin lymphoma (n = 497), and anal cancer (n = 439). The median age at cohort entry was 43 years. The overall median 6-month lagged CD4/CD8 ratio was 0.52 (interquartile range = 0.30-0.82). Compared with a 6-month lagged CD4/CD8 of 0.80, a CD4/CD8 of 0.30 was associated with increased risk of any incident cancer (adjusted hazard ratio = 1.24 [95% confidence interval = 1.14 to 1.35]). The CD4/CD8 ratio was also inversely associated with non-Hodgkin lymphoma, Kaposi sarcoma, lung cancer, anal cancer, and colorectal cancer in adjusted analyses (all 2-sided P < .05). Results were similar using 12-, 18-, and 24-month lagged CD4/CD8 values | ||
| 520 | |a CONCLUSIONS: A low CD4/CD8 ratio up to 24 months before cancer diagnosis was independently associated with increased cancer risk in PWH and may serve as a clinical biomarker | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Bian, Aihua |e verfasserin |4 aut | |
| 700 | 1 | |a Jenkins, Cathy A |e verfasserin |4 aut | |
| 700 | 1 | |a Shepherd, Bryan E |e verfasserin |4 aut | |
| 700 | 1 | |a Sigel, Keith |e verfasserin |4 aut | |
| 700 | 1 | |a Gill, M John |e verfasserin |4 aut | |
| 700 | 1 | |a Kitahata, Mari M |e verfasserin |4 aut | |
| 700 | 1 | |a Silverberg, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Mayor, Angel M |e verfasserin |4 aut | |
| 700 | 1 | |a Coburn, Sally B |e verfasserin |4 aut | |
| 700 | 1 | |a Wiley, Dorothy |e verfasserin |4 aut | |
| 700 | 1 | |a Achenbach, Chad J |e verfasserin |4 aut | |
| 700 | 1 | |a Marconi, Vincent C |e verfasserin |4 aut | |
| 700 | 1 | |a Bosch, Ronald J |e verfasserin |4 aut | |
| 700 | 1 | |a Horberg, Michael A |e verfasserin |4 aut | |
| 700 | 1 | |a Rabkin, Charles S |e verfasserin |4 aut | |
| 700 | 1 | |a Napravnik, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Novak, Richard M |e verfasserin |4 aut | |
| 700 | 1 | |a Mathews, W Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Thorne, Jennifer E |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Althoff, Keri N |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Richard D |e verfasserin |4 aut | |
| 700 | 1 | |a Sterling, Timothy R |e verfasserin |4 aut | |
| 700 | 1 | |a Sudenga, Staci L |e verfasserin |4 aut | |
| 700 | 0 | |a North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA) |e verfasserin |4 aut | |
| 700 | 1 | |a Castilho, Jessica L |e investigator |4 oth | |
| 700 | 1 | |a Bian, Aihua |e investigator |4 oth | |
| 700 | 1 | |a Jenkins, Cathy A |e investigator |4 oth | |
| 700 | 1 | |a Shepherd, Bryan E |e investigator |4 oth | |
| 700 | 1 | |a Sigel, Keith |e investigator |4 oth | |
| 700 | 1 | |a John Gill, M |e investigator |4 oth | |
| 700 | 1 | |a Kitahata, Mari M |e investigator |4 oth | |
| 700 | 1 | |a Silverberg, Michael J |e investigator |4 oth | |
| 700 | 1 | |a Mayor, Angel M |e investigator |4 oth | |
| 700 | 1 | |a Coburn, Sally B |e investigator |4 oth | |
| 700 | 1 | |a Wiley, Dorothy |e investigator |4 oth | |
| 700 | 1 | |a Achenbach, Chad J |e investigator |4 oth | |
| 700 | 1 | |a Marconi, Vincent C |e investigator |4 oth | |
| 700 | 1 | |a Bosch, Ronald J |e investigator |4 oth | |
| 700 | 1 | |a Horberg, Michael A |e investigator |4 oth | |
| 700 | 1 | |a Rabkin, Charles S |e investigator |4 oth | |
| 700 | 1 | |a Napravnik, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Novak, Richard M |e investigator |4 oth | |
| 700 | 1 | |a Christopher Mathews, W |e investigator |4 oth | |
| 700 | 1 | |a Thorne, Jennifer E |e investigator |4 oth | |
| 700 | 1 | |a Sun, Jing |e investigator |4 oth | |
| 700 | 1 | |a Althoff, Keri N |e investigator |4 oth | |
| 700 | 1 | |a Moore, Richard D |e investigator |4 oth | |
| 700 | 1 | |a Sterling, Timothy R |e investigator |4 oth | |
| 700 | 1 | |a Sudenga, Staci L |e investigator |4 oth | |
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