ArticlePloS one2017
A Low Peripheral Blood CD4/CD8 Ratio Is Associated with Pulmonary Emphysema in HIV.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- CD4/CD8 ratio and CD8+ T-cell count as prognostic markers for non-AIDS mortality in people living with HIV. A systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Prevalence of emphysema in people living with human immunodeficiency virus in the current combined antiretroviral therapy era: A systematic review.Frontiers in medicine · 2022Pooled it
- Pooled it
- Recurrent episodes of pneumonia are associated with worse lung function in people with HIV.PloS one · 2026Article
- Changes in the immune index before and after surgery in urinary malignancy patients with AIDS.Scientific reports · 2025Article
- Chronic Obstructive Pulmonary Disease in People with HIV: an Evidence-Based Review.HIV/AIDS (Auckland, N.Z.) · 2025Review
- Article
- Article
- COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies.International journal of chronic obstructive pulmonary disease · 2023Review
- Towards the elimination of chronic obstructive pulmonary disease: a Lancet Commission.Lancet (London, England) · 2022Review
- CD4/CD8 Ratio and Cancer Risk Among Adults With HIV.Journal of the National Cancer Institute · 2022Article
- Sex Differences in Airway Remodeling and Inflammation: Clinical and Biological Factors.Frontiers in allergy · 2022Review
- World AIDS Day: 40 years of an evolving pulmonary landscape.American journal of physiology. Lung cellular and molecular physiology · 2021Article
- Smoking and Human Immunodeficiency Virus 1 Infection Promote Retention of CD8American journal of respiratory cell and molecular biology · 2021Article
- Article
- Independent Associations of Tumor Necrosis Factor-Alpha and Interleukin-1 Beta With Radiographic Emphysema in People Living With HIV.Frontiers in immunology · 2021Article
- Chronic obstructive pulmonary disease in HIV.Expert review of respiratory medicine · 2021Review
- Sensitivity and specificity of the mean corpuscular volume and CD4/CD8 ratio in discriminating between rifampicin resistant and rifampicin sensitive tuberculosis.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Incidence of hypertension among persons living with HIV in China: a multicenter cohort study.BMC public health · 2020Article
- Immune imbalance and activation are associated with lower lung function in youth with perinatally acquired HIV.The Journal of allergy and clinical immunology · 2020Article
Corrections and comments
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Authors and funding
12 authors at 8 institutions in 2 countries.
Funding
Abstract
objectivesThe prevalence of emphysema is higher among HIV-infected (HIV+) individuals compared to HIV-uninfected persons. While greater tobacco use contributes, HIV-related effects on immunity likely confer additional risk. Low peripheral blood CD4+ to CD8+ T-lymphocyte (CD4/CD8) ratio may reflect chronic inflammation in HIV and may be a marker of chronic lung disease in this population. Therefore, we sought to determine whether the CD4/CD8 ratio was associated with chronic obstructive pulmonary disease (COPD), particularly the emphysema subtype, in a cohort of HIV+ subjects.
methodsWe performed a cross-sectional analysis of 190 HIV+ subjects enrolled in the Examinations of HIV Associated Lung Emphysema (EXHALE) study. Subjects underwent baseline laboratory assessments, pulmonary function testing and chest computed tomography (CT) analyzed for emphysema severity and distribution. We determined the association between CD4/CD8 ratio and emphysema, and the association between CD4/CD8 ratio and pulmonary function markers of COPD.
resultsMild or greater emphysema (>10% lung involvement) was present in 31% of subjects. Low CD4/CD8 ratio was associated with >10% emphysema in multivariable models, adjusting for risk factors including smoking, current and nadir CD4 count and HIV RNA level. Those with CD4/CD8 ratio <0.4 had 6.3 (1.1-39) times the odds of >10% emphysema compared to those with a ratio >1.0 in fully adjusted models. A low CD4/CD8 ratio was also associated with reduced diffusion capacity (DLCO).
conclusionsA low CD4/CD8 ratio was associated with emphysema and low DLCO in HIV+ subjects, independent of other risk factors and clinical markers of HIV. The CD4/CD8 ratio may be a useful, clinically available, marker for risk of emphysema in HIV+ subjects in the antiretroviral therapy (ART) era.
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