Demographic and clinical factors associated with immune reconstitution in HIV/HBV co-infected and HIV mono-infected patients: a retrospective cohort study

HIV Med. 2020 Dec;21(11):722-728. doi: 10.1111/hiv.13023.

Abstract

Objectives: To describe the clinical characteristics and factors associated with CD4 T-cell count and CD4/CD8 ratio restoration in HIV mono-infected and HIV/HBV co-infected individuals, and to explore liver and renal functional changes in both groups.

Methods: A retrospective cohort study was performed including 356 HIV/HBV co-infected and 716 HIV mono-infected participants who initiated antiretroviral therapy (ART) during 2013-2017 in Beijing Youan Hospital, China. Demographic and clinical characteristics were compared between the two groups, using χ2 and Mann-Whitney non-parametric tests. Bivariate and multivariate Cox regression models were used to test their association.

Results: Baseline HIV viral load and ART regimen were found to be significantly associated with CD4 T-cell restoration among HIV-infected participants, whereas baseline HIV viral load was the only significant factor associated with CD4 T-cell restoration in HIV/HBV co-infected participants. The final model showed that baseline HIV viral load and ART regimen were significantly associated with CD4/CD8 ratio restoration among HIV-infected participants, while baseline HIV viral load was the significant factor. Liver and renal functions were similar at the endpoint (P > 0.05).

Conclusions: Baseline HIV viral load count was found to be the key factor affecting immune restoration in both HIV and HIV/HBV individuals. Future multi-wave prospective studies are needed to clarify the potential biological mechanism.

Keywords: CD4 T cells; CD4/CD8 ratio; HIV mono-infected patient; HIV viral load; HIV/HBV co-infected patient.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use*
  • CD4 Lymphocyte Count
  • CD4-CD8 Ratio
  • China
  • Coinfection / drug therapy*
  • Coinfection / immunology
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • Hepatitis B / drug therapy*
  • Hepatitis B / immunology
  • Humans
  • Immune Reconstitution
  • Kidney Function Tests
  • Liver Function Tests
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Viral Load
  • Young Adult

Substances

  • Anti-Retroviral Agents