{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:53:13Z","timestamp":1773924793531,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead Sciences Medical Grant"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>HIV infection can promote persistent immune activation and endothelial dysfunction, contributing to atherosclerosis. Carotid intima\u2013media thickness (cIMT) is an established marker of subclinical atherosclerosis. We evaluated the association between cIMT severity and two routinely available markers of immune dysregulation (CD4\/CD8 ratio and nadir CD4+ cell count) in people living with HIV (PLWH). We conducted an Italian multicenter cross-sectional study including 1148 PLWH who underwent carotid color Doppler ultrasound. We classified cIMT as \u22640.9, 1.0\u20131.4, or &gt;1.4 mm and analyzed these categories using multinomial logistic regression, reporting adjusted odds ratios (aORs) with 95% confidence intervals (CIs). We adjusted models for age, sex, BMI, HIV acquisition risk factor, hypertension, diabetes, dyslipidemia\/statin use, triglycerides, integrase inhibitor use, and ART duration. cIMT was \u22640.9 mm in 615 (53.6%) participants, 1.0\u20131.4 mm in 379 (33.0%), and &gt;1.4 mm in 154 (13.4%). Using nadir CD4+ \u2265 200 cells\/\u00b5L and CD4\/CD8 \u2265 1.0 as reference, PLWH with nadir CD4+ &lt; 200 and CD4\/CD8 \u2265 1.0 had higher odds of cIMT 1.0\u20131.4 mm (aOR 1.66, 95% CI 1.02\u20132.69) and &gt;1.4 mm (aOR 3.45, 95% CI 1.68\u20137.07). In conclusion, CD4+ nadir and this combined pattern were associated with greater cIMT severity, supporting a role for immune dysregulation in subclinical atherosclerosis.<\/jats:p>","DOI":"10.3390\/v18030383","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T17:12:26Z","timestamp":1773853946000},"page":"383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Immune Dysregulation Markers in Cardiovascular Risk of People Living with HIV: Association Among Intima Media Changes, CD4\/CD8 Ratio, and CD4+ Cell Count Nadir"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-3576","authenticated-orcid":false,"given":"Manuela","family":"Ceccarelli","sequence":"first","affiliation":[{"name":"Department of Medicine and Surgery, \u201cKore\u201d University of Enna, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-0444","authenticated-orcid":false,"given":"Elena Delfina","family":"Ricci","sequence":"additional","affiliation":[{"name":"Fondazione per lo Studio delle Infezioni e delle Allergopatie (ASIA) Onlus, 20900 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0900-5639","authenticated-orcid":false,"given":"Camilla","family":"Muccini","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Universit\u00e0 Vita e Salute \u201cSan Raffaele\u201d, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Galli","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Universit\u00e0 Vita e Salute \u201cSan Raffaele\u201d, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Universit\u00e0 degli Studi di Foggia, 71122 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Azienda Ospedaliera di Foggia, 71122 Foggia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6919-1955","authenticated-orcid":false,"given":"Benedetto Maurizio","family":"Celesia","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, \u201cNesima\u201d Hospital, ARNAS \u201cGaribaldi\u201d, 95122 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elio","family":"Manzillo","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive dell\u2019Immunodepresso e Medicina di Genere, Ospedale \u201cCotugno\u201d, AO dei Colli, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Guida","sequence":"additional","affiliation":[{"name":"UOC Malattie Infettive dell\u2019Immunodepresso e dell\u2019Immigrazione, Ospedale \u201cCotugno\u201d, AO dei Colli, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Universit\u00e0 degli Studi \u201cFederico II\u201d di Napoli, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Basile","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Grande Ospedale Metropolitano, 89133 Reggio Calabria, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Universit\u00e0 Vita e Salute \u201cSan Raffaele\u201d, 20132 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8772-0136","authenticated-orcid":false,"given":"Paolo","family":"Maggi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, \u201cKore\u201d University of Enna, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"ref_1","first-page":"S1","article-title":"Epidemiology of Coronary Heart Disease in Patients with Human Immunodeficiency Virus","volume":"15","author":"Triant","year":"2014","journal-title":"Rev. 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