Abstract: TH-PO0729
Reversal of CD4:CD8 Ratio May Predict Infection Risk in Patients with ANCA-Associated Vasculitis
Session Information
- Glomerular Innovations: Artificial Intelligence, Multiomics, and Biomarkers
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Thanikachalam, Prakash, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Joshi, Anivart, King's College London, London, England, United Kingdom
- Morris, Adam, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Floyd, Lauren, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Ponnusamy, Arvind, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Rowbottom, Anthony Walter, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Elsayed, Mohamed Elsayed, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
- Dhaygude, Ajay Prabhakar, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, England, United Kingdom
Background
Infection is a leading cause of morbi-mortality in AAV. Immune frailty increases this risk but is hard to measure. T lymphocytes are key mediators of cellular immunity. The CD4:CD8 ratio is a useful marker of immune function. Age, sex, ethnicity and genetics, influence the CD4:CD8 ratio and an inverted ratio is associated with immune malfunction and immunosenescence. Role of ratio reversal in AAV remains unclear. We aim to examine the CD4:CD8 ratio and outcomes in AAV patients.
Methods
Retrospective study was conducted in a single centre between 2012 and 2022. All the patients seen in vasculitis clinic with 2 years follow up and CD4:CD8 ratio taken prior to exposure to maximum of 1g of cyclophosphamide were included. Regression analysis was used to establish relationships between CD4:CD8 ratio and outcomes.
Results
43 patients with AAV were included, 56% (n=24) were male and the mean age was 63.0 years. A decrease in CD4:CD8 ratio was associated with an increased risk of infections requiring hospitalization. Logarithmic CD4:CD8 ratio showed significantly high risk of infection (p = 0.0432, estimated coefficient = -0.6838). This was independent from age and Charleson Comorbidity Index (p = 0.5972 and p = 0.2111 respectively).
Conclusion
This study showed decreased CD4:CD8 ratio to be a significant independent risk factor associated with increased risk of infections. This requires confirming in a large cohort and may prove more important that physical frailty in terms of risk stratification in the management of AAV.
Limitations: Small sample size.