Background A low proportion of CD28−CD8+ T cells that express CD57 is associated with increased mortality in HIV infection. The effect of increasing BMI changes in the proportion of CD57+CD28−CD8+ T cells among HIV-infected individuals on ART is unknown. Setting In a U.S. cohort of HIV-infected women, we evaluated associations of BMI and waist circumference with 3 distinct CD8+ T cell phenotypes: % CD28−CD57+CD8+ T cells, % CD57+ of CD28−CD8+ T cells and % CD28− of all CD8+ T cells. Methods Multivariable linear regression analysis was used to estimate beta-coefficients for each of three T cell phenotypes. Covariates included HIV parameters (current and nadir CD4, current viral load), demographics (age, race, income, study site), and lifestyle (tobacco, alcohol use) factors. Results Of 225 participants, the median age was 46 years and 50% were obese (BMI>30 m2/kg). Greater BMI and waist circumference were both associated with higher %CD28−CD57+CD8+ T cells and %CD57+ of all CD28−CD8+ T cells in multivariable analysis, including adjustment for HIV viral load (all p<0.05). The association between greater BMI and the overall proportion of CD28− CD8+ cells in fully adjusted models (0.078, 95% CI: (−0.053 – 0.209) were not significant. Conclusions In this analysis, greater BMI and waist circumference are associated with greater expression of CD57 on CD28−CD8+ T cells and a greater proportion of CD57+CD28− CD8+ T cells. These findings may indicate that increasing BMI is immunologically protective in HIV-infected women. Future research is needed to understand the prognostic importance of these associations on clinical outcomes.
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