Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models
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. Parti...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/15/2/385 |
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| author | Alejandra Fonseca-Cuevas Patrick Newsome Lu Wang Michelle Y. Chen Chris G. Richardson Mark Hull Taylor McLinden Silvia Guillemi Rolando Barrios Julio S. G. Montaner Viviane D. Lima |
| author_facet | Alejandra Fonseca-Cuevas Patrick Newsome Lu Wang Michelle Y. Chen Chris G. Richardson Mark Hull Taylor McLinden Silvia Guillemi Rolando Barrios Julio S. G. Montaner Viviane D. Lima |
| author_sort | Alejandra Fonseca-Cuevas |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T08:00:34Z |
| format | Article |
| id | doaj.art-45eac98f33f545bb9adf7afee3e80a8a |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-11T08:00:34Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-45eac98f33f545bb9adf7afee3e80a8a2023-11-16T23:48:18ZengMDPI AGViruses1999-49152023-01-0115238510.3390/v15020385Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture ModelsAlejandra Fonseca-Cuevas0Patrick Newsome1Lu Wang2Michelle Y. Chen3Chris G. Richardson4Mark Hull5Taylor McLinden6Silvia Guillemi7Rolando Barrios8Julio S. G. Montaner9Viviane D. Lima10British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaDepartment of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaDepartment of Educational & Counselling Psychology & Special Education, University of British Columbia, Vancouver, BC V6T 1Z4, CanadaCentre for Health Evaluation and Outcome Sciences, Providence Health Care, Vancouver, BC V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaDepartment of Family Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, CanadaThe 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.https://www.mdpi.com/1999-4915/15/2/385CD4:CD8 ratioHIVchronic kidney diseasegrowth mixture modelingdecay modelrisk factors |
| spellingShingle | Alejandra Fonseca-Cuevas Patrick Newsome Lu Wang Michelle Y. Chen Chris G. Richardson Mark Hull Taylor McLinden Silvia Guillemi Rolando Barrios Julio S. G. Montaner Viviane D. Lima Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models Viruses CD4:CD8 ratio HIV chronic kidney disease growth mixture modeling decay model risk factors |
| title | Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models |
| title_full | Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models |
| title_fullStr | Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models |
| title_full_unstemmed | Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models |
| title_short | Identifying Longitudinal CD4:CD8 Ratio Trajectories Indicative of Chronic Renal Disease Risk among People Living with HIV: An Application of Growth Mixture Models |
| title_sort | identifying longitudinal cd4 cd8 ratio trajectories indicative of chronic renal disease risk among people living with hiv an application of growth mixture models |
| topic | CD4:CD8 ratio HIV chronic kidney disease growth mixture modeling decay model risk factors |
| url | https://www.mdpi.com/1999-4915/15/2/385 |
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