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What drives a normal relation between T-CD4 and T-CD8?


Inversion of the CD4/CD8 ratio, in the context of HIV infection, is a frequent finding, even though, if the patient has been on prolonged antiretroviral therapy. Nonetheless, in a small proportion undergoing antiretroviral therapy, this relation normalizes.

Purpose of the study

With the aim to investigate frequency and the population characteristics of this occurrence we proposed a retrospective analysis in our outpatient HIV clinic in Lisbon.


Patients with a proven inversion of CD4/CD8 ratio before the beginning of antiretroviral treatment and who, in the last five years, re-inverted to a normalized ratio (above one) in at least two consecutive estimations were eligible. Variables analyzed included: gender, age, former opportunistic infections, CD4+ nadir, viral load, length of antiretroviral therapy and therapeutic regime. Obtained data was tested for correlation and statistical significance using student T-test.


Of 1.750 patients on antiretroviral therapy, 119 patients reverted to a normal T-CD4/CD8 ratio in the last five years. Six of these where infected with HIV-2, five did not maintain reversion, which lead to a 108 patients with a true reversion, corresponding to 6% of the population. Not being able to access the files in 18 cases, the analysis is based on 90 patients. The mean-time of antiretroviral therapy before reversion of the CD4/CD8 ratio was 69 month. The distribution reveals two peaks: one around month 40th and another around month 130th, probably related to former therapeutic regimes. No significant correlation was found if time-of-antiretroviral-therapy-until-reversion was analysed with respect to impact by opportunistic infection, T-CD4 nadir, viral load, gender or the ability of the antiretroviral therapy to penetrate the CNS. Though, not a frequent finding, it seems to be constant and strongly correlated to time-of-antiretroviral-therapy with a correlation of Pearson of 0,501 (p=0.01).


These findings suggest that the CD4/CD8 might be a marker for the follow-up in patient undergoing antiretroviral therapy. Its real impact, though, needs further investigation especially with respect to T-CD8 specific cytotoxicity and activation.

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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Badura, R., Antunes, R., Janeiro, N. et al. What drives a normal relation between T-CD4 and T-CD8?. JIAS 13 (Suppl 4), P152 (2010).

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