Coinfection by hepatitis C is strongly associated with abnormal CD4/CD8 ratio in HIV patients under stable ART in Salvador,Brazil

Proper immune restoration (cd4 count >500 and normal cd4/8 ratio) is reached only by a fraction of hiv patients,despite stable viral suppression. methods. we present a case-control study to compare hiv patients with viral suppression >1 year,according to immune restoration pattern: adequate response (ar) defined by cd4 > 500 cells/mm3 and cd4/8 ratio >1; partial response (pr = patients with cd4 > 500,but cd4/8 ratio <1); inadequate response (ir = cd4 < 500 cells). results. we evaluated 293 consecutive patients (89 ar,112 pr,and 92 ir),70% males. male gender (p < 0.01),lower mean cd4 nadir (p < 0.001),higher baseline vl (p = 0.01),previous diagnosis of tb (p = 0.03),or hcv (p < 0.01) was associated with ir. likelihood of ar/pr was similar regardless of gender,after adjusting for nadir cd4+ cells count. longer time under suppressive art was also associated with a greater chance of ar,but logistic regression identified coinfection by hcv as the main factor associated with abnormal cd4/cd8 ratio. conclusion. early initiation of art and longer time since first undetectable pvl were predictors of ar. previous hcv diagnosis significantly increases the risk of abnormal cd4/cd8 ratio. © 2015 clara brites-alves et al.