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

Autor: Marije van Schalkwyk, Edgar T. Overton, Steven K. Grinspoon, Nagalingeswaran Kumarasamy, Carl J. Fichtenbaum, Janet Lo, Judith A. Aberg, Esteban Martínez, Judith S. Currier, Patrice Desvigne-Nickens, Craig A. Sponseller, Breno Santos, Markella V. Zanni, Sue Siminski, Gerald S. Bloomfield, Pamela S. Douglas, Heather J. Ribaudo, Kathleen Melbourne, Kathleen V. Fitch, Yvetot Joseph, Jorge Leon-Cruz, Carlos Malvestutto, Reprieve Investigators, Emma M Kileel, Udo Hoffmann
Rok vydání: 2020
Předmět:
Male
REPRIEVE
CD4-CD8 Ratio
CD4 cell count
Integrase inhibitor
Supplement Articles
HIV Infections
Logistic regression
Medical and Health Sciences
law.invention
Randomized controlled trial
law
Interquartile range
cardiovascular disease
Immunology and Allergy
Randomized Controlled Trials as Topic
Biological Sciences
Middle Aged
Corrigenda
Infectious Diseases
Anti-Retroviral Agents
6.1 Pharmaceuticals
HIV/AIDS
Female
Infection
Adult
medicine.medical_specialty
antiretroviral therapy
Clinical Trials and Supportive Activities
Microbiology
pitavastatin calcium
statins
CD4/CD8 ratio
Clinical Research
Internal medicine
REPRIEVE Investigators
medicine
Humans
business.industry
Prevention
HIV
Evaluation of treatments and therapeutic interventions
CD4 Lymphocyte Count
Clinical trial
Regimen
Good Health and Well Being
Cross-Sectional Studies
business
Body mass index
Zdroj: J Infect Dis
The Journal of infectious diseases, vol 222, iss Suppl 1
ISSN: 1537-6613
Popis: 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.
Databáze: OpenAIRE
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