CoRIS2026-01-202026-01-202023-09CoRIS 2023, 'Expanding HIV clinical monitoring : the role of CD4, CD8, and CD4/CD8 ratio in predicting non-AIDS events', eBioMedicine, vol. 95, 104773. https://doi.org/10.1016/j.ebiom.2023.1047732352-3964PubMedCentral: PMC10474064https://hdl.handle.net/10641/7435Publisher Copyright: © 2023 The Author(s)Background: While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear. Methods: We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events. Findings: The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio <0.3 predicted an increased risk of SNAEs during the next five years (OR 1.63, 95% CI 1.03–2.58). The effect was stronger at a CD4/CD8 ratio cut-off of <0.2 (OR 3.09, 95% CI 1.57–6.07). Additionally, low CD4 count at cut-offs of <500 cells/μL predicted an increased risk of clinical events. Among participants with a CD4 count ≥500 cells/μL, a CD8 count ≥1500 cells/μL or a CD4/CD8 ratio <0.4 predicted increased SNAE risk. Interpretation: Our results support the use of the CD4/CD8 ratio and CD8 count as predictors of clinical progression. Patients with CD4/CD8 ratio <0.3 or CD8 count ≥1500/μL, regardless of their CD4 count, may benefit from closer monitoring and targeted preventive interventions. Funding: This work was supported by CIBER (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea—NextGenerationEU; by the Spanish AIDS Research Network (RIS) RD16/0025/0001 project as part of the Plan Nacional R + D + I, and cofinanced by Instituto de Salud Carlos III (ISCIII)- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER), ISCIII projects PI18/00154, PI21/00141, and ERDF, “A way to make Europe”, ICI20/00058.407845enghttp://creativecommons.org/licenses/by-nc-nd/4.0/CD4/CD8 ratioCardiovascular eventHIVNeoplasiaNon-AIDS eventsGeneral MedicineGeneral Biochemistry, Genetics and Molecular BiologySDG 3 - Good Health and Well-beingJournal ArticleYesyesjournal articleopen access10.1016/j.ebiom.2023.104773https://www.scopus.com/pages/publications/85171600996https://www.scopus.com/pages/publications/85171600996#tab=citedBy