Enhanced immunovirological response in women compared to men after antiretroviral therapy initiation during acute and early HIV‐1 infection: results from a longitudinal study in the French ANRS Primo cohort
| Autor: | Laurence Weiss, Cécile Goujard, Olivier Bouchaud, André Cabié, Pierre Delobel, Sophie Novelli, Pilartxo Catalan, Véronique Avettand-Fenoel, François Raffi, Pascale Fialaire, Faouzi Souala, Laurence Meyer |
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| Přispěvatelé: | Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Agence Nationale de Recherches sur le Sida et les Hépatites Virales, ANRS Université Paris-Saclay, This work was supported by the ANRS and a doctoral grant from the Paris-Saclay University to SN. We thank all the patients and physicians who participated in the ANRS PRIMO cohort (see the Appendix S1). This work was supported by the ANRS and a doctoral grant from the Paris-Saclay University to SN., This work was supported by the ANRS and a doctoral grant from the Paris‐Saclay University to SN. |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male viral reservoir Longitudinal study medicine.medical_specialty Anti-HIV Agents CD4:CD8 ratio [SDV]Life Sciences [q-bio] Human immunodeficiency virus (HIV) CD4-CD8 Ratio medicine.disease_cause Cohort Studies 03 medical and health sciences Sex Factors 0302 clinical medicine women’s health Internal medicine medicine Humans Longitudinal Studies 030212 general & internal medicine Research Articles 030505 public health business.industry Hazard ratio Public Health Environmental and Occupational Health CD4 lymphocyte count Viral Load Antiretroviral therapy Confidence interval 3. Good health Infectious Diseases Cohort HIV-1 Leukocytes Mononuclear treatment outcome Female 0305 other medical science business Viral load Research Article HIV infections |
| Zdroj: | Journal of the International AIDS Society Journal of the International AIDS Society, BioMed Central (2008-2012) ; International Aids Society (2008-) ; Wiley (2017-), 2020, 23 (4), ⟨10.1002/jia2.25485⟩ |
| ISSN: | 1758-2652 |
| Popis: | International audience; Introduction: Previous studies have reported better immunovirological characteristics in women compared with men after HIV seroconversion. We investigated whether differences persisted under long-term antiretroviral therapy (ART) in individuals treated since acute and early HIV-1 infection (AHI). Methods: Data were obtained for 262 women and 1783 men enrolled between 1996 and 2017 in the French multicentre ANRS PRIMO cohort. We modelled the viral response, long-term immune recovery and HIV DNA decay in the 143 women and 1126 men who initiated ART within the first three months of infection. Results: The participants were mostly white. The mean age was 37 years at AHI diagnosis. Pre-ART viral loads were lower in women than men, 5.2 and 5.6 log10 copies/mL (p = 0.001). After ART initiation, women more rapidly achieved viral suppression than men (adjusted hazard ratio: 1.33, 95% confidence interval 1.09 to 1.69). They also experienced a faster increase in CD4+ T-cell count and CD4:CD8 ratio during the first months of treatment. Sex-related differences in CD4+ T-cell counts were more pronounced with increasing age. This led to a sustained mean difference of 99 to 168 CD4+ T-cells/µL depending on age between women and men at 150 months of ART. Moreover, CD4:CD8 ratio of women was higher than that of men by 0.31, at 150 months of ART. There was no statistically significant difference between sexes for the levels of HIV DNA over time (mean estimate at the last modelling point: 1.9 log10 copies/106 PBMCs after 70 months of ART for both sexes). Conclusions: The high level of immune recovery and decrease in total HIV DNA levels achieved after ART initiation during AHI reinforce the importance of early diagnosis of HIV infection and immediate ART initiation. The immunological benefit of being female increased throughout prolonged ART duration, which may give women additional protection from adverse clinical events and premature ageing. |
| Databáze: | OpenAIRE |
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