Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV

IntroductionThe CD4/CD8 ratio has emerged as a useful indicator of immune dysfunction and comorbid conditions in people living with HIV (PLWH). However, its optimal cut-off value is unclear. We explored the correlation between the CD4/CD8 ratio, immunosenescence markers and comorbid conditions.Metho...

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Main Authors: Matteo Vassallo, Jacques Durant, Sami Addou, Michel Ticchioni, Roxane Fabre, David Chirio, Alissa Naqvi, Eric Cua, Leslie Ameil, Maeva Godemert, Christian Pradier, Michel Carles
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1562537/full
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author Matteo Vassallo
Jacques Durant
Sami Addou
Michel Ticchioni
Roxane Fabre
Roxane Fabre
David Chirio
Alissa Naqvi
Eric Cua
Leslie Ameil
Maeva Godemert
Christian Pradier
Michel Carles
author_facet Matteo Vassallo
Jacques Durant
Sami Addou
Michel Ticchioni
Roxane Fabre
Roxane Fabre
David Chirio
Alissa Naqvi
Eric Cua
Leslie Ameil
Maeva Godemert
Christian Pradier
Michel Carles
author_sort Matteo Vassallo
collection DOAJ
description IntroductionThe CD4/CD8 ratio has emerged as a useful indicator of immune dysfunction and comorbid conditions in people living with HIV (PLWH). However, its optimal cut-off value is unclear. We explored the correlation between the CD4/CD8 ratio, immunosenescence markers and comorbid conditions.MethodsWe prospectively included PLWH on successful and stable ART (antiretroviral therapy) > 60 years old and receiving either BIC/FTC/TAF or DTG/3TC, in Nice, France. HIV-negative healthy subjects were included as controls. We measured T-cell subsets (naïve, central memory, effector memory and terminally differentiated cells) and the distribution of KLRG1 + CD57+ senescent cells. We correlated CD4/CD8 ratio, background measurements and comorbid conditions.ResultsWe included 68 PLWH (median age 69 years, 31 years on ART, median CD4/CD8 ratio 0.76). PLWH had higher levels of senescence markers than controls (n = 8). Among PLWH, adjusting for age, gender, HIV follow-up and duration on ART, those with a CD4/CD8 ratio < 0.76 had more senescent CD8+ cells (AdjOR = 0.93, 95%CI = [0.88; 0.97], p-value = 0.003). Higher levels of CD8+ senescence persisted for lower CD4/CD8 ratios, with, in addition, a significant decrease in NK cells in case of a ratio < 0.4. After adjustment, CD8+ effector memory senescent cells were significantly more abundant in PLWH with hypertension.ConclusionPLWH on successful ART display elevated immunosenescence markers, mainly on CD8+ T-cells. A CD4/CD8 cut-off value below 0.4 showed the strongest association with immune dysfunction, including NK+ cells. Such results could be useful for identifying patients requiring closer follow-up and screening for complications.
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spelling doaj-art-e5bfd98b7e7a4223a51c2d6ee629ffab2025-08-20T02:12:20ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15625371562537Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIVMatteo Vassallo0Jacques Durant1Sami Addou2Michel Ticchioni3Roxane Fabre4Roxane Fabre5David Chirio6Alissa Naqvi7Eric Cua8Leslie Ameil9Maeva Godemert10Christian Pradier11Michel Carles12Internal Medicine/Infectious Diseases Department, Cannes, FranceInfectious Diseases Department, University of Nice, Nice, FranceDepartment of Immunology, University of Nice, Nice, FranceDepartment of Immunology, University of Nice, Nice, FranceDepartment of Public Health, University of Nice, Nice, FrancePain Department and FHU InovPain, CHU Nice and Cote Azur University, Nice, FranceInfectious Diseases Department, University of Nice, Nice, FranceInfectious Diseases Department, University of Nice, Nice, FranceInfectious Diseases Department, University of Nice, Nice, FranceInfectious Diseases Department, University of Nice, Nice, FranceClinical Research Department, University of Nice, Nice, FranceDepartment of Public Health, University of Nice, Nice, FranceInfectious Diseases Department, University of Nice, Nice, FranceIntroductionThe CD4/CD8 ratio has emerged as a useful indicator of immune dysfunction and comorbid conditions in people living with HIV (PLWH). However, its optimal cut-off value is unclear. We explored the correlation between the CD4/CD8 ratio, immunosenescence markers and comorbid conditions.MethodsWe prospectively included PLWH on successful and stable ART (antiretroviral therapy) > 60 years old and receiving either BIC/FTC/TAF or DTG/3TC, in Nice, France. HIV-negative healthy subjects were included as controls. We measured T-cell subsets (naïve, central memory, effector memory and terminally differentiated cells) and the distribution of KLRG1 + CD57+ senescent cells. We correlated CD4/CD8 ratio, background measurements and comorbid conditions.ResultsWe included 68 PLWH (median age 69 years, 31 years on ART, median CD4/CD8 ratio 0.76). PLWH had higher levels of senescence markers than controls (n = 8). Among PLWH, adjusting for age, gender, HIV follow-up and duration on ART, those with a CD4/CD8 ratio < 0.76 had more senescent CD8+ cells (AdjOR = 0.93, 95%CI = [0.88; 0.97], p-value = 0.003). Higher levels of CD8+ senescence persisted for lower CD4/CD8 ratios, with, in addition, a significant decrease in NK cells in case of a ratio < 0.4. After adjustment, CD8+ effector memory senescent cells were significantly more abundant in PLWH with hypertension.ConclusionPLWH on successful ART display elevated immunosenescence markers, mainly on CD8+ T-cells. A CD4/CD8 cut-off value below 0.4 showed the strongest association with immune dysfunction, including NK+ cells. Such results could be useful for identifying patients requiring closer follow-up and screening for complications.https://www.frontiersin.org/articles/10.3389/fmed.2025.1562537/fullHIVCD4/CD8 ratioimmunosenescencecomorbidityimmune activation
spellingShingle Matteo Vassallo
Jacques Durant
Sami Addou
Michel Ticchioni
Roxane Fabre
Roxane Fabre
David Chirio
Alissa Naqvi
Eric Cua
Leslie Ameil
Maeva Godemert
Christian Pradier
Michel Carles
Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
Frontiers in Medicine
HIV
CD4/CD8 ratio
immunosenescence
comorbidity
immune activation
title Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
title_full Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
title_fullStr Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
title_full_unstemmed Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
title_short Immunosenescence markers in T- and NK-cells according to the CD4/CD8 ratio in successfully treated people living with HIV
title_sort immunosenescence markers in t and nk cells according to the cd4 cd8 ratio in successfully treated people living with hiv
topic HIV
CD4/CD8 ratio
immunosenescence
comorbidity
immune activation
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1562537/full
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