Aging of people with human immunodeficiency virus (HIV) is a worldwide reality, and age-related conditions, including disability, have also increased. Efforts are being made to search for more specific markers of immune system malfunction, which serve as good predictors of adverse health-related outcomes. Therefore, this study aimed to determine the relationship between the CD4⁺/CD8⁺ ratio and functional decline in activities of daily living (ADL). Participants in this longitudinal study underwent a standardized comprehensive geriatric assessment by trained staff, using validated tools. Functional decline in ADL was established by the delta resulting from the subtraction of the score on the Barthel index at T₁ minus the score at T₀ (baseline). Multivariate linear regression analyses were used to determine the independent relationship between the CD4⁺/CD8⁺ ratio and ADL decline. Mean age was 57.9 (standard deviation 6.6; range 50–84 years), and 82.7% were men. Eleven of the 209 participants had disability for ADL at baseline. Multivariate linear regression analysis showed an inverse relationship between the log of CD4⁺/CD8⁺ ratio at baseline and the delta of Barthel index even after adjustment for multiple confounders (β = −1.68, 95% confidence interval −3.02 to −0.33; p = .01). A CD4⁺/CD8⁺ ratio of <1 predicts the development of functional decline in ADL. This ratio can be a useful marker to identify people at risk of disability and should be considered for the tailored management of older adults with HIV.

中文翻译：

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较低的 CD4+/CD8+ 比率预示着感染 HIV 的老年人的日常生活能力下降

人类免疫缺陷病毒 (HIV) 感染者的老龄化是一个世界性的现实，包括残疾在内的与年龄相关的疾病也在增加。人们正在努力寻找更具体的免疫系统功能障碍标志物，这些标志物可以很好地预测与健康相关的不良后果。因此，本研究旨在确定 CD4 ⁺ /CD8 ⁺比率与日常生活活动 (ADL) 功能下降之间的关系。这项纵向研究的参与者接受了由受过训练的工作人员使用经过验证的工具进行的标准化综合老年医学评估。ADL 的功能下降由减去T ₁时 Barthel 指数的分数减去T时的分数所产生的增量确定₀（基线）。多变量线性回归分析用于确定 CD4 ⁺ /CD8 ⁺比率与 ADL 下降之间的独立关系。平均年龄为 57.9 岁（标准差 6.6；范围 50-84 岁），82.7% 为男性。209 名参与者中有 11 名在基线时有 ADL 残疾。^{多元线性回归分析显示基线时 CD4 +} /CD8 ⁺比率的对数与 Barthel 指数的增量之间呈反比关系，即使在调整多个混杂因素后也是如此（β  = −1.68，95% 置信区间为 −3.02 至 −0.33；p  = .01). CD4 ⁺ /CD8 ⁺<1 的比率预测 ADL 功能下降的发展。该比率可以作为识别有残疾风险的人的有用标志，并应考虑用于对感染 HIV 的老年人进行量身定制的管理。