Pre-HAART CD4+ T-lymphocytes as biomarkers of post-HAART immune recovery in HIV-infected children with or without TB co-infection

BMC Infectious Diseases

Yuwei Cheng¹  Vivek Gopalakrishnan²  Usha Nair³  Musie Ghebremichael⁴  Eliezer Bose⁵ 

[1] College of the Holy Cross, 1 College St, 01610, Worcester, MA, USA;Johns Hopkins University Department of Biomedical Engineering, 3510 N Charles Street, 21218, Baltimore, MD, USA;Ragon Institute and Harvard Medical School, 400 Tech Square, 02129, Cambridge, MA, USA;Ragon Institute and Harvard Medical School, 400 Tech Square, 02129, Cambridge, MA, USA;Ragon Institute of Harvard, MGH and MIT, 400 Technology Square, 02129, Cambridge, MA, USA;School of Nursing at MGH Institute of Health Professions, 36 1st Ave, 02129, Charlestown, MA, USA;

关键词: HIV;    TB;    HAART;    ROC curves;    CD4+ T-lymphocytes;    immune recovery;   

DOI  :  10.1186/s12879-020-05458-w

来源: Springer

【 摘 要 】

BackgroundInfection with the Human Immunodeficiency Virus (HIV) dramatically increases the risk of developing active tuberculosis (TB). Several studies have indicated that co-infection with TB increases the risk of HIV progression and death. Sub-Saharan Africa bears the brunt of these dual epidemics, with about 2.4 million HIV-infected people living with TB. The main objective of our study was to assess whether the pre-HAART CD4+ T-lymphocyte counts and percentages could serve as biomarkers for post-HAART treatment immune-recovery in HIV-positive children with and without TB co-infection.MethodsThe data analyzed in this retrospective study were collected from a cohort of 305 HIV-infected children being treated with HAART. A Lehmann family of ROC curves were used to assess the diagnostic performance of pre- HAART treatment CD4+ T-lymphocyte count and percentage as biomarkers for post-HAART immune recovery. The Kaplan–Meier estimator was used to compare differences in post-HAART recovery times between patients with and without TB co-infection.ResultsWe found that the diagnostic performance of both pre-HARRT treatment CD4+ T-lymphocyte count and percentage was comparable and achieved accuracies as high as 74%. Furthermore, the predictive capability of pre-HAART CD4+ T-lymphocyte count and percentage were slightly better in TB-negative patients. Our analyses also indicate that TB-negative patients have a shorter recovery time compared to the TB-positive patients.ConclusionsPre-HAART CD4+ T-lymphocyte count and percentage are stronger predictors of immune recovery in TB-negative pediatric patients, suggesting that TB co-infection complicates the treatment of HIV in this cohort. These findings suggest that the detection and treatment of TB is essential for the effectiveness of HAART in HIV-infected pediatric patients.

【 授权许可】

CC BY