Patterns of Antiretroviral Therapy Use and Immunologic Profiles at Enrollment in the REPRIEVE Trial.

Autor:	Fichtenbaum CJ; Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Ribaudo HJ; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Leon-Cruz J; Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA., Overton ET; Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA., Zanni MV; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Malvestutto CD; Division of Infectious Diseases, Ohio State University Medical Center, Columbus, Ohio, USA., Aberg JA; Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Kileel EM; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Fitch KV; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Van Schalkwyk M; Family Centre for Research with Ubuntu, Division of Adult Infectious Diseases, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa., Kumarasamy N; Infectious Diseases Medical Centre, Voluntary Health Services, Chennai, India., Martinez E; Hospital Clinic and University of Barcelona, Barcelona, Spain., Santos BR; Infectious Diseases Service, Hospital Nossa, Senhora da Conceição/GHC, Porto Alegre, Brazil., Joseph Y; Les Centres GHESKIO, Port-au-Prince, Haiti., Lo J; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA., Siminski S; Frontier Science and Technology Foundation, Amherst, Massachusetts, USA., Melbourne K; HIV Medical Sciences, Gilead Sciences, Foster City, California, USA., Sponseller CA; Kowa Pharmaceuticals America, Montgomery, Alabama, USA., Desvigne-Nickens P; National Heart, Lung and Blood Institute, Baltimore, Maryland, USA., Bloomfield GS; Department of Medicine, Duke Global Health Institute and Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA., Currier JS; Division of Infectious Diseases, University of California-Los Angeles, Los Angeles, California, USA., Hoffmann U; Cardiac MR PET CT Program and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA., Douglas PS; Duke University Medical Center, Durham, North Carolina, USA., Grinspoon SK; Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2020 Jul 09; Vol. 222 (Suppl 1), pp. S8-S19.
DOI:	10.1093/infdis/jiaa259
Abstrakt:	Background: Patterns of antiretroviral therapy (ART) use and immunologic correlates vary globally, and contemporary trends are not well described. Methods: The REPRIEVE trial (Randomized Trial to Prevent Vascular Events in HIV) enrolled persons with human immunodeficiency virus (HIV) who were aged 40-75 years, receiving ART, and had low-to-moderate cardiovascular disease risk. ART use was summarized within Global Burden of Disease (GBD) super-regions, with adjusted linear and logistic regression analyses examining associations with immune parameters and key demographics. Results: A total of 7770 participants were enrolled, with a median age of 50 years (interquartile range, 45-55 years); 31% were female, 43% were black or African American, 15% were Asian, 56% had a body mass index >25 (calculated as weight in kilograms divided by height in meters squared), and 49% were current or former smokers. The median CD4 T-cell count was 620/µL (interquartile range, 447-826/ µ L), and the median duration of prior ART use, 9.5 years (5.3-14.8) years. The most common ART regimens were nucleoside/nucleotide reverse-transcriptase inhibitor (NRTI) plus nonnucleoside reverse-transcriptase inhibitor (43%), NRTI plus integrase strand transfer inhibitor (25%), and NRTI plus protease inhibitor (19%). Entry ART varied by GBD region, with shifts during the trial enrollment period. In adjusted analyses, entry CD4 cell count and CD4/CD8 ratio were associated with GBD region, sex, entry regimen, duration of ART, and nadir CD4 cell count; CD4 and CD8 cell counts were also associated with body mass index and smoking status. Conclusions: There were substantial variations in ART use by geographic region and over time, likely reflecting the local availability of specific medications, changes in treatment guidelines and provider/patient preferences. The analyses of CD4 cell counts and CD4/CD8 ratios may provide valuable insights regarding immune correlates and outcomes in people living with HIV. Clinical Trials Registration: NCT02344290. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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