ArticleJournal of acquired immune deficiency syndromes (1999)2016
Brief Report: Enhanced Normalization of CD4/CD8 Ratio With Earlier Antiretroviral Therapy at Primary HIV Infection.
Article in Journal of acquired immune deficiency syndromes (1999), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Acute and early HIV infection screening among men who have sex with men, a systematic review and meta-analysis.Journal of the International AIDS Society · 2020Pooled it
- Three-Year CD4/CD8 Ratio Recovery After Initiation of Dual Versus Triple Integrase Inhibitor-Based Therapy in Naïve Adults With HIV.Open forum infectious diseases · 2026Trial
- Dolutegravir/Abacavir/Lamivudine in Acute HIV-1 Results in Rapid Suppression and Restoration of CD4 T-cell Subsets Without Accelerated Decay of Latent HIV-1.Open forum infectious diseases · 2025Trial
- Cell-associated HIV-1 RNA predicts viral rebound and disease progression after discontinuation of temporary early ART.JCI insight · 2020Trial
- Trial
- Viral coinfections and checkpoint-marker expression in HIV: An exploratory HCV-Related CD4⁺ T-Cell PD-L1 pattern.Immunologic research · 2026Article
- Immune non-response despite effective antiretroviral therapy in people living with HIV: A review of potential mechanisms, biomarkers and therapeutic approaches.HIV medicine · 2026Review
- Immunovirological status in people with perinatal and adult-acquired HIV-1 infection: a multi-cohort analysis from France.The Lancet regional health. Europe · 2024Article
- Incomplete recovery of the CD4+/CD8+ ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection.Revista do Instituto de Medicina Tropical de Sao Paulo · 2024Article
- Article
- Rapid start antiretroviral therapies for improved engagement in HIV care: implementation science evaluation protocol.BMC health services research · 2023Article
- Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh: Real-World Data.International journal of general medicine · 2023Article
- Immune Activation in Primary Human Immunodeficiency Virus: Influence of Duration of Infection, Treatment, and Substance Use.Open forum infectious diseases · 2022Article
- Virological and Immunological Outcomes of an Intensified Four-Drug versus a Standard Three-Drug Antiretroviral Regimen, Both Integrase Strand Transfer Inhibitor-Based, in Primary HIV Infection.Pharmaceuticals (Basel, Switzerland) · 2022Article
- Understanding the role of nACE2 in neurogenic hypertension among COVID-19 patients.Hypertension research : official journal of the Japanese Society of Hypertension · 2022Review
- Evaluation of antiretroviral therapy effect and prognosis between HIV-1 recent and long-term infection based on a rapid recent infection testing algorithm.Frontiers in microbiology · 2022Article
- Review
- Determinants of suboptimal CD4Journal of the International AIDS Society · 2020Article
- Immune recovery in HIV-1 infected patients with sustained viral suppression under long-term antiretroviral therapy in Ethiopia.PloS one · 2020Article
- Enhanced Immunological Recovery With Early Start of Antiretroviral Therapy During Acute or Early HIV Infection-Results of Italian Network of ACuTe HIV InfectiON (INACTION) Retrospective Study.Pathogens & immunity · 2020Article
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 6 countries.
Funding
Abstract
backgroundTotal CD4 T-cell counts predict HIV disease progression but do not necessarily reflect normalization of immune function. CD4/CD8 ratio is a marker of immune dysfunction, a prognostic indicator for non-AIDS mortality, and reflects viral reservoir size. Despite antiretroviral therapy (ART), recovery of CD4/CD8 ratio in chronic HIV infection is incomplete; we hypothesize enhanced CD4/CD8 ratio recovery with earlier treatment initiation in recently infected individuals.
methodsCD4 count and CD4/CD8 ratio were analyzed using data from 2 cohorts: SPARTAC trial and the UK HIV Seroconverters Cohort where primary HIV infection (PHI) was defined as within 6 months from estimated date of infection. Using time-to-event methods and Cox proportional hazard models, we examined the effect of CD4/CD8 ratio at seroconversion on disease progression (CD4 <350 cells per cubic millimeter/ART initiation) and factors associated with time from ART initiation to CD4/CD8 normalization (ratio >1.0).
findingsOf 573 seroconverters, 482 (84%) had abnormal CD4/CD8 ratios at HIV seroconversion. Individuals with higher CD4/CD8 ratio at seroconversion were significantly less likely to reach the disease progression endpoint [adjusted hazard ratio (aHR) (95% CI) = 0.52 (0.32 to 0.82), P = 0.005]. The longer the interval between seroconversion and ART initiation [HR (95% CI) = 0.98 per month increase (0.97, 0.99), P < 0.001], the less likely the CD4/CD8 ratio normalization. ART initiation within 6 months from seroconversion was significantly more likely to normalize [HR (95% CI) = 2.47 (1.67 to 3.67), P < 0.001] than those initiating later.
interpretationMost individuals presenting in PHI have abnormal CD4/CD8 ratios. The sooner the ART is initiated in PHI, the greater the probability of achieving normal CD4/CD8 ratio.
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Registered trials
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