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. 2020 Jun 29;222(2):252-262.
doi: 10.1093/infdis/jiaa069.

T Lymphocyte Subsets Associated With Prevalent Diabetes in Veterans With and Without Human Immunodeficiency Virus

Samuel S Bailin  1 , Kathleen A McGinnis  2 , Wyatt J McDonnell  1 , Kaku So-Armah  3 , Melissa Wellons  1 , Russell P Tracy  4 , Margaret F Doyle  4 , Simon Mallal  1 , Amy C Justice  2   5 , Matthew S Freiberg  1   6 , Alan L Landay  7 , Celestine Wanjalla  1 , John R Koethe  1   6
Affiliations

T Lymphocyte Subsets Associated With Prevalent Diabetes in Veterans With and Without Human Immunodeficiency Virus

Samuel S Bailin et al. J Infect Dis. .

Abstract

Background: A higher proportion of circulating memory CD4+ T cells is associated with prevalent diabetes mellitus in the general population. Given the broad changes in adaptive immunity, including memory T-cell expansion, and rising prevalence of diabetes in the human immunodeficiency virus (HIV) population, we assessed whether similar relationships were present in persons with HIV (PWH).

Methods: Multiple CD4+ and CD8+ T-cell subsets were measured by flow cytometry, and prevalent diabetes cases were adjudicated by 2 physicians for PWH and HIV-negative participants in the Veterans Aging Cohort Study. Multivariable logistic regression models evaluated the association of T-cell subsets and diabetes stratified by HIV status, adjusted for cytomegalovirus serostatus and traditional risk factors.

Results: Among 2385 participants (65% PWH, 95% male, 68% African American), higher CD45RO+ memory CD4+ T cells and lower CD38+ CD4+ T cells were associated with prevalent diabetes, and had a similar effect size, in both the PWH and HIV-negative (P ≤ .05 for all). Lower CD38+CD8+ T cells were also associated with diabetes in both groups.

Conclusions: The CD4+ and CD8+ T-cell subsets associated with diabetes are similar in PWH and HIV-negative individuals, suggesting that diabetes in PWH may be related to chronic immune activation.

Keywords: HIV; T lymphocytes; metabolic disease; systemic inflammation; type 2 diabetes mellitus.

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Figures

Figure 1.
Figure 1.
CD4+ T-cell subsets associated with prevalent diabetes in persons with human immunodeficiency virus (HIV) and HIV-negative individuals using multivariable logistic regression modeling adjusted for age, sex, body mass index, race, hepatitis C virus, and cytomegalovirus serostatus, smoking status, alcohol use, interleukin-6, D-dimer, and soluble CD14. Models for HIV+ also adjusted for plasma HIV-1 ribonucleic acid suppression (<500 copies/mL). T-cell percentage is plotted on the x-axis, and risk of prevalent diabetes is plotted on the y-axis. Error bars represent 95% confidence intervals.
Figure 2.
Figure 2.
CD8+ T-cell subsets associated with prevalent diabetes in persons with human immunodeficiency virus (HIV) and HIV-negative individuals using multivariable logistic regression modeling adjusted for age, sex, body mass index, race, hepatitis C virus, and cytomegalovirus serostatus, smoking status, alcohol use, interleukin-6, D-dimer, and soluble CD14. Models for HIV+ also adjusted for plasma HIV-1 ribonucleic acid suppression (<500 copies/mL). T-cell percentage is plotted on the x-axis and risk of prevalent diabetes is plotted on the y-axis. Error bars represent 95% confidence intervals.
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