Biochemical and inflammatory modifications after switching to dual antiretroviral therapy in HIV-infected patients in Italy: A multicenter retrospective cohort study from 2007 to 2015
| Autor: | Quiros-Roldan, E., Magro, P., Raffetti, E., Izzo, I., Borghetti, Alberto, Lombardi, Francesca, Saracino, A., Maggiolo, F., Castelli, F., Carosi, Giulia, Paraninfo, G. E., Torti, Carlo, Cauda, Roberto, Di Giambenedetto, Simona, Fabbiani, M., Colafigli, Manuela, Scalzini, A., Castelnuovo, F., El Hamad, I., Mazzotta, F., Locaputo, S., Marino, N., Pierotti, P., Di Pietro, Maria Luisa, Ble, C., Vichi, F., Sighinolfi, L., Angarano, G., Ladisa, N., Monno, L., Maggi, P., Pan, A., Costarelli, S., Gori, A., Lapadula, G., Puoti, M., Viale, P., Colangeli, V., Borderi, M. |
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| Přispěvatelé: | Quiros-Roldan, E, Magro, P, Raffetti, E, Izzo, I, Borghetti, A, Lombardi, F, Saracino, A, Maggiolo, F, Castelli, F, Carosi, G, Paraninfo, G, Torti, C, Cauda, R, Di Giambenedetto, S, Fabbiani, M, Colafigli, M, Scalzini, A, Castelnuovo, F, El Hamad, I, Mazzotta, F, Locaputo, S, Marino, N, Pierotti, P, Di Pietro, M, Ble, C, Vichi, F, Sighinolfi, L, Angarano, G, Ladisa, N, Monno, L, Maggi, P, Pan, A, Costarelli, S, Gori, A, Lapadula, G, Puoti, M, Viale, P, Colangeli, V, Borderi, M, Blè, C, Border, M |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Male HIV Infections Gastroenterology Cohort Studies 0302 clinical medicine Abacavir Antiretroviral Therapy Highly Active 030212 general & internal medicine Darunavir virus diseases Switch Middle Aged Antiretroviral therapy Infectious Diseases Treatment Outcome Italy Reverse Transcriptase Inhibitors Female medicine.symptom medicine.drug Research Article Adult medicine.medical_specialty Anti-HIV Agents Dual-therapy HIV Inflammation Atazanavir Sulfate CD4-CD8 Ratio Renal function Settore MED/17 - MALATTIE INFETTIVE lcsh:Infectious and parasitic diseases 03 medical and health sciences Immune system Internal medicine medicine Humans lcsh:RC109-216 Tenofovir Retrospective Studies business.industry Retrospective cohort study Reverse transcriptase Dideoxynucleosides Regimen 030104 developmental biology business CD8 |
| Zdroj: | BMC Infectious Diseases, Vol 18, Iss 1, Pp 1-11 (2018) BMC Infectious Diseases |
| Popis: | Background Triple-drug regimens are the gold standard for HIV therapy. Nucleos(t)ide reverse transcriptase inhibitors (NRTIs) reducing regimens are used to decrease drugs toxicity, exposure and costs. Aim of our study was to evaluate trends of biochemical and inflammatory indices in patients switching to dual therapy (DT). Methods We included patients that a) switched to a DT from 2007 to 2015 from a tenofovir/abacavir-based triple regimen b) previously maintained a triple and c) subsequently a dual regimen for 12 months with virological suppression. We retrieved data measured at 5 points (at the switch, 6 and 12 months before and after switch). We used platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and CD4/CD8 ratio as inflammatory indices. We assessed temporal trends of viro-immunological, biochemical and inflammatory parameters. Results Overall, 364 and 65 patients switched from a tenofovir- and an abacavir-triple regimen, respectively. In the tenofovir-reducing group, creatinine clearance and lipids raised after the switch. There was a significant increase in both CD4+ cells and CD4/CD8. CD8+ cells rose after the switch, while opposite trend was found for PLR. In the abacavir-reducing group total lipids showed a decrease during the first 6 months after the switch and then stabilized. An increase of CD4+ and a decrease of CD8+ cells was observed during the study period, although not statistically significant. While CD4/CD8 remained stable after simplification, PLR decreased significantly after 6 months, then returning to baseline. CD8+ cells increased in the tenofovir-reducing group despite a viro-immunological response. Intriguingly, PLR decreased, maintaining this trend for 12 and 6 months after tenofovir and abacavir interruption respectively. Conclusions Increased PLR has been linked to hypercholesterolemia and metabolic-syndrome, while high CD8+ cells count to increased risk of non-AIDS-related events regardless of CD4 T-cell recovery and to virological failure. Whether these findings may have clinical implications, and which role DT plays on the immune system and on inflammation should be further investigated. |
| Databáze: | OpenAIRE |
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