What type of study is this?

This is a Observational study (also classified as: Human Clinical Trial).

August 17, 2025

Some Markers of Chronic Immune Activation in Young Born HIV Positive Under Antiretroviral Treatment at the Yaounde University Teaching Hospital, Cameroon

Key Points

An increase in CD4+ and CD8+ counts was observed, correlating with a CD4:CD8 ratio under 1, indicating chronic immune activation.
The study enrolled 74 young participants, with the highest prevalence of comorbidities at the second measurement rising to 50%.
A longitudinal prospective analysis assessed immune markers and co-infections using flow cytometry and rapid diagnostic tests.
The findings suggest that immunological monitoring in HIV-positive youth, particularly regarding CMV co-infection, is crucial for treatment efficacy.

Abstract

Background: The clinical importance of the CD4:CD8 ratio in people living with HIV (PLHIV) on an-tiretrovirals (ARVs) is increasingly recognized. Indeed, the persistence of an inverted CD4:CD8 ratio under ARV was associated with a higher level of immune activation and a higher risk of occurrence of comorbidities classifying or not AIDS. However, due to events that have become rare, few studies report the prognostic value of the CD4:CD8 ratio in PLHIV born to HIV positive. Objective: The aim of the present study was to identify biomarkers of immunological activation involved in the monitoring of people born HIV. Objective: The aim of the present study was to identify biomarkers of immunological activation in-volved in the monitoring of people born HIV Methods: The study was longitudinal prospective carried out at the Yaounde University Hospital, from 2020 to 2021, on young people born HIV positive, aged over 19, on ARV, with an undetectable viral load, and whose medical file was available and complete within the Approved Treatment Center. Participants’ socio-demographic and clinical data were recorded, and rapid diagnostic tests for infections with HBV (Hepatitis B Virus), HCV (Hepatitis C Virus), EBV (Epstein Barr-Virus), CMV (Cytomegalovirus) were carried out. Determination of the T lymphocyte profile was carried out by flow cytometry. Participants’ parameters were taken at inclusion (P1) and 12 months later (P2). Statistical analysis was carried out with version 22.0 of the Statistical Package for Social Sciences (SPSS) software, chi-square and Spearman’s correlation coefficient were calculated for comparison purposes. Results: 74 participants were enrolled, with the sex-ratio of 0.45 and the age group of 5-10 years was the largest 33.78% (n=25), and children were the most affected at 56.76% (n=42). From P (1) to P (2) the most common therapeutic protocol was TDF/3TC/EFV with 86.96% (n=59) participants and 29.73% (n=43) participants. The prevalence of comorbidities of P (1) and P (2) was 43.24% and 50%. The aver-age of CD4+and CD8+ counts were respectively 536.76±21.63 cells/mm3 and 754.93±50.78 cells/mm3 at P (1) and 908.30±50.25 cells/mm3 and 1202.30 ±447.70 cells/mm3 at P (2). From P (1) to P (2), the average CD4:CD8 ratio was 0.72 and 0.93. At P (1), the most common liver virus was HBV 22.97% (n=17), at P (2) it was CMV 95.95%. The CD4+:CD8+ ratio <1 was found associated with high CD4+ values (p=0.001) and co-infection with CMV and HSV-1/-2 (p<0.001).Conclusion: An increase in CD4+ and CD8+ counts during the follow-up period was found associated with CD4:CD8 ratio <1, the CD4+:CD8+ ratio which also appeared to be influenced by CMV co-infection.

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