Key result
A current CD4+ T-cell count <200 cells/μl in people with HIV was independently associated with elevated native T1 (OR 7.199; 95% CI 1.373-37.746; P=0.020) and elevated ECV.
Why the study?
To evaluate the association between immune status and subclinical myocardial injury by CMR in people with HIV, independent of traditional cardiovascular risk factors.
Is current CD4 count associated with subclinical myocardial injury by CMR in people with HIV independent of traditional cardiovascular risk factors?
Observational (n=189)
Is current CD4 count associated with subclinical myocardial injury by CMR in people with HIV independent of traditional cardiovascular risk factors?
Odds Ratio: 7.199 (95% CI 1.373–37.746)
p-value: p=0.020
In people with HIV, a current CD4+ T-cell count <200 cells/μl is an independent predictor of subclinical myocardial injury as detected by CMR, independent of traditional cardiovascular risk factors.
Low CD4 count flags subclinical myocardial injury risk in HIV; leaves open whether CD4 restoration alters cardiac outcomes.
OBJECTIVES: To evaluate the association between immune status and subclinical myocardial injury by cardiovascular magnetic resonance (CMR) in people with HIV (PWH), independent of traditional cardiovascular risk factors. DESIGN: This prospective study enrolled 98 PWH without known cardiovascular disease (CVD) and 91 Framingham Risk Score (FRS)-matched non-HIV controls. METHODS: Myocardial function and tissue characteristics were assessed by CMR, including native T1/T2 mapping, extracellular volume fraction (ECV), and late gadolinium enhancement (LGE). Immunologic and treatment-related variables included duration of HIV infection, duration of ART, HIV viral load, current and nadir CD4+ and CD8+ T-cell counts, and CD4/CD8 ratio. Linear and logistic regression analyses adjusted for FRS and heart rate evaluated associations between immunologic parameters and CMR findings. RESULTS: PWH demonstrated elevated global native T1, T2, ECV, and LGE, with reduced global longitudinal strain (GLS) and global circumferential strain (GCS) compared with non-HIV controls (all P < 0.05). In multivariate analysis, current CD4+ T-cell counts correlated negatively with global native T1 (β = -0.361, P < 0.001) and ECV (β = -0.318, P = 0.001). Current CD4+ cell count <200 cells/μl was independently associated with elevated native T1 [odds ratio (OR), 7.199; 95% confidence interval (CI), 1.373-37.746; P = 0.020] and elevated ECV (OR, 5.152; 95% CI, 1.260-21.062; P = 0.023). CONCLUSION: PWH exhibit subclinical myocardial fibrosis and dysfunction despite similar FRS to non-HIV controls. Current CD4+ T-cell counts <200 cells/μl is an independent predictor of subclinical myocardial injury.
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Gan et al. (2026) conducted an observational in HIV without known cardiovascular disease (n=189). Current CD4+ T-cell count <200 cells/μl vs. Higher CD4+ T-cell counts was evaluated on Elevated native T1 (OR 7.199, 95% CI 1.373-37.746, p=0.020). A current CD4+ T-cell count <200 cells/μl in people with HIV was independently associated with elevated native T1 (OR 7.199; 95% CI 1.373-37.746; P=0.020) and elevated ECV.
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