Higher Body Mass Index Is Associated With Greater Proportions of Effector CD8+ T Cells Expressing CD57 in Women Living With HIV

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Abstract

Background:

A low proportion of CD28−CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing body mass index (BMI) changes in the proportion of CD57+CD28−CD8+ T cells among HIV-infected individuals on antiretroviral therapy is unknown.

Setting:

In a US cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28−CD57+CD8+ T cells, % CD57+ of CD28−CD8+ T cells, and % CD28− of all CD8+ T cells.

Methods:

Multivariable linear regression analysis was used to estimate beta coefficients for each of 3 T-cell phenotypes. Covariates included HIV parameters (current and nadir CD4, current viral load), demographics (age, race, income, and study site), and lifestyle (tobacco and alcohol use) factors.

Results:

Of 225 participants, the median age was 46 years and 50% were obese (BMI >30 m2/kg). Greater BMI and waist circumference were both associated with higher % CD28−CD57+CD8+ T cells and % CD57+ of all CD28−CD8+ T cells in multivariable analysis, including adjustment for HIV viral load (all P < 0.05). The association between greater BMI and the overall proportion of CD28− CD8+ cells in fully adjusted models (0.078, 95% confidence interval: −0.053 to 0.209) was not significant.

Conclusions:

In this analysis, greater BMI and waist circumference are associated with greater expression of CD57 on CD28−CD8+ T cells and a greater proportion of CD57+CD28− CD8+ T cells. These findings may indicate that increasing BMI is immunologically protective in HIV-infected women. Future research is needed to understand the prognostic importance of these associations on clinical outcomes.

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