{"doi":"10.17615/7ppn-ef21","title":"CD4/CD8 Ratio and Cancer Risk among Adults with HIV","abstract":"Background: Independent of CD4 cell count, a low CD4/CD8 ratio in people with HIV (PWH) is associated with deleterious immune senescence, activation, and inflammation, which may contribute to carcinogenesis and excess cancer risk. We examined whether low CD4/CD8 ratios predicted cancer among PWH in the United States and Canada. Methods: We examined all cancer-free PWH with 1 or more CD4/CD8 values from North American AIDS Cohort Collaboration on Research and Design observational cohorts with validated cancer diagnoses between 1998 and 2016. We evaluated the association between time-lagged CD4/CD8 ratio and risk of specific cancers in multivariable, time-updated Cox proportional hazard models using restricted cubic spines. Models were adjusted for age, sex, race and ethnicity, hepatitis C virus, and time-updated CD4 cell count, HIV RNA, and history of AIDS-defining illness. Results: Among 83 893 PWH, there were 5628 incident cancers, including lung cancer (n = 755), Kaposi sarcoma (n = 501), non-Hodgkin lymphoma (n = 497), and anal cancer (n = 439). The median age at cohort entry was 43 years. The overall median 6-month lagged CD4/CD8 ratio was 0.52 (interquartile range = 0.30-0.82). Compared with a 6-month lagged CD4/CD8 of 0.80, a CD4/CD8 of 0.30 was associated with increased risk of any incident cancer (adjusted hazard ratio = 1.24 [95% confidence interval = 1.14 to 1.35]). The CD4/CD8 ratio was also inversely associated with non-Hodgkin lymphoma, Kaposi sarcoma, lung cancer, anal cancer, and colorectal cancer in adjusted analyses (all 2-sided P <. 05). Results were similar using 12-, 18-, and 24-month lagged CD4/CD8 values. Conclusions: A low CD4/CD8 ratio up to 24 months before cancer diagnosis was independently associated with increased cancer risk in PWH and may serve as a clinical biomarker.","journal":"UNC Libraries","year":2024,"id":498730,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9552,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1345656,"name":"S.B Coburn","orcid":null,"position":1,"is_corresponding":false},{"id":315096,"name":"Dorothy J. Wiley","orcid":"0000-0002-9416-473X","position":2,"is_corresponding":false},{"id":1345657,"name":"M.M Kitahata","orcid":null,"position":3,"is_corresponding":false},{"id":1345658,"name":"M.J Silverberg","orcid":null,"position":4,"is_corresponding":false},{"id":626294,"name":"Jing Sun","orcid":"0000-0003-3741-0962","position":5,"is_corresponding":false},{"id":1345659,"name":"B.E Shepherd","orcid":null,"position":6,"is_corresponding":false},{"id":104268,"name":"Keith Sigel","orcid":"0000-0002-4051-4861","position":7,"is_corresponding":false},{"id":1345660,"name":"K.N Althoff","orcid":null,"position":8,"is_corresponding":false},{"id":240244,"name":"M. John Gill","orcid":"0000-0002-8546-8790","position":9,"is_corresponding":false},{"id":609396,"name":"Ron Bosch","orcid":null,"position":10,"is_corresponding":false},{"id":1345661,"name":"M.A Horberg","orcid":null,"position":11,"is_corresponding":false},{"id":591321,"name":"C.S Rabkin","orcid":null,"position":12,"is_corresponding":false},{"id":340146,"name":"Sonia Napravnik","orcid":"0000-0002-9032-3713","position":13,"is_corresponding":false},{"id":1345662,"name":"J.E Thorne","orcid":null,"position":14,"is_corresponding":false},{"id":591619,"name":"R.D Moore","orcid":null,"position":15,"is_corresponding":false},{"id":321310,"name":"Jessica L. Castilho","orcid":"0000-0002-7599-8173","position":16,"is_corresponding":false},{"id":283320,"name":"Aihua Bian","orcid":null,"position":17,"is_corresponding":false},{"id":1345663,"name":"C. A. Jenkins","orcid":null,"position":18,"is_corresponding":false},{"id":1345329,"name":"Trinity Sterling","orcid":"0009-0006-4639-6217","position":19,"is_corresponding":false},{"id":606698,"name":"Staci L. Sudenga","orcid":"0000-0001-7305-8738","position":20,"is_corresponding":false},{"id":551055,"name":"C.J. Achenbach","orcid":null,"position":21,"is_corresponding":false},{"id":235461,"name":"Richard Novák","orcid":"0000-0003-0485-4284","position":22,"is_corresponding":false},{"id":104965,"name":"Vincent C. Marconi","orcid":"0000-0001-8409-4689","position":23,"is_corresponding":false},{"id":240256,"name":"William C. Mathews","orcid":"0000-0002-2352-0725","position":24,"is_corresponding":false},{"id":1345655,"name":"A.M Mayor","orcid":null,"position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:09:42.181447Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}