Evaluati̇on of CD4/CD8 ratio in hiv-positive patients and determi̇ni̇ng factors for normalization of the ratio

HIV (Human Immunodeficiency Virus) infection is a serious disease that threatens public health worldwide. HIV infection has an effect on the immune system, especially by disrupting the balance between CD4+ and CD8+ T cells. During HIV infection, there is a significant decrease in the number of CD4+ cells, while CD8+ cells generally increase. This causes the CD4+/CD8+ ratio to deteriorate. While the CD4+/CD8+ ratio is generally accepted to be between 1.5 and 2.5 in healthy individuals, this ratio can drop significantly in HIV-positive individuals. The CD4+/CD8+ ratio provides critical information about the progression of HIV infection and the status of the immune system. This study aimed to evaluate the CD4/CD8 ratio in HIV-positive patients and to identify factors influencing the normalization of this ratio.The study began after obtaining ethical approval from the Ethics Committee of Tekirdağ Namık Kemal University Faculty of Medicine. It is a retrospective study. A total of 100 patients were evaluated. Among HIV-positive patients, 15% were female and 85% were male, with a mean age of 40.31±12.61 years. Seventy-one percent of patients were diagnosed after 2020, with a faster normalization of the CD4/CD8 ratio observed in this group (p=0.001). Among the patients, 56% had CD4+ counts above 500, and higher CD4+ counts were associated with shorter normalization time (r = -0.257; p=0.011). As the CD4/CD8 ratio increased, the normalization period shortened (r = -0.300; p=0.003); however, no significant relationship was found between normalization time and CD8+ cell count or viral load. Women had a significantly shorter normalization period compared to men (p = 0.001). INSTI and NRTI+PI treatment protocols were used at similar rates, with no significant differences in normalization time between treatment types. The study demonstrates that women achieve normalization more quickly than men, with the timing of treatment initiation and baseline CD4 levels playing a critical role in the normalization process. Keywords: HIV Treatment, CD4/CD8 Ratio, Normalization Time