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Article

Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models

1
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada
2
Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
3
Department of Educational & Counselling Psychology & Special Education, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
4
Centre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada
5
Department of Family Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
*
Author to whom correspondence should be addressed.
Viruses 2023, 15(2), 385; https://doi.org/10.3390/v15020385
Submission received: 9 December 2022 / Revised: 21 January 2023 / Accepted: 26 January 2023 / Published: 29 January 2023
(This article belongs to the Special Issue HIV, Aging and Comorbidity)

Abstract

The incidence of chronic kidney disease (CKD) is increasing among people living with HIV (PLWH). Routine monitoring of indicators such as CD4:CD8 ratio might improve the early detection of CKD. Our objective was to identify clinically relevant CD4:CD8 ratio trajectories indicative of CKD risk. Participants were ≥ 18 years old, initiated antiretroviral therapy between 2000 and 2016, and were followed for ≥6 months until 31 March 2017 or last contact date. Outcome was incidence of CKD. Growth mixture models (GMMs) and decay models were used to compare CD4:CD8 ratio trajectories. Following GMM, 4547 (93.5%) participants were classified in Class 1 with 5.4% developing CKD, and 316 (6.5%) participants were classified in Class 2 with 20.9% developing CKD. The final model suggested that participants in Class 2 had 8.72 times the incidence rate of developing CKD than those in Class 1. Exponential decay models indicated a significant CD4:CD8 ratio decline among Class 2 participants who developed CKD. Among those who developed CKD in Class 2, starting at 5.5 years of follow-up, the slope of their ratio trajectory curve changed significantly, and the rate of decline increased dramatically. Routine monitored CD4:CD8 ratios can be an effective strategy to identify early CKD risk among PLWH.
Keywords: CD4:CD8 ratio; HIV; chronic kidney disease; growth mixture modeling; decay model; risk factors CD4:CD8 ratio; HIV; chronic kidney disease; growth mixture modeling; decay model; risk factors

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MDPI and ACS Style

Fonseca-Cuevas, A.; Newsome, P.; Wang, L.; Chen, M.Y.; Richardson, C.G.; Hull, M.; McLinden, T.; Guillemi, S.; Barrios, R.; Montaner, J.S.G.; et al. Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models. Viruses 2023, 15, 385. https://doi.org/10.3390/v15020385

AMA Style

Fonseca-Cuevas A, Newsome P, Wang L, Chen MY, Richardson CG, Hull M, McLinden T, Guillemi S, Barrios R, Montaner JSG, et al. Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models. Viruses. 2023; 15(2):385. https://doi.org/10.3390/v15020385

Chicago/Turabian Style

Fonseca-Cuevas, Alejandra, Patrick Newsome, Lu Wang, Michelle Y. Chen, Chris G. Richardson, Mark Hull, Taylor McLinden, Silvia Guillemi, Rolando Barrios, Julio S. G. Montaner, and et al. 2023. "Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models" Viruses 15, no. 2: 385. https://doi.org/10.3390/v15020385

APA Style

Fonseca-Cuevas, A., Newsome, P., Wang, L., Chen, M. Y., Richardson, C. G., Hull, M., McLinden, T., Guillemi, S., Barrios, R., Montaner, J. S. G., & Lima, V. D. (2023). Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models. Viruses, 15(2), 385. https://doi.org/10.3390/v15020385

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