Enhanced immunovirological response in women compared to men after antiretroviral therapy initiation during acute and early HIV‐1 infection
| Autor: | Novelli, Sophie, Delobel, Pierre, Bouchaud, Olivier, Avettand‐fenoel, Véronique, Fialaire, Pascale, Cabié, André, Souala, Faouzi, Raffi, François, Catalan, Pilartxo, Weiss, Laurence, Meyer, Laurence, Goujard, Cécile |
|---|---|
| Přispěvatelé: | PINIER, CHRISTINE, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service Maladies infectieuses et tropicales [CHU Toulouse], Pôle Inflammation, infection, immunologie et loco-moteur [CHU Toulouse] (Pôle I3LM Toulouse), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de maladies infectieuses et tropicales [CHU Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Microbiologie Clinique [AP-HP Hôpital Necker-Enfants Malades], CHU Necker - Enfants Malades [AP-HP], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU de la Martinique [Fort de France], CHU Pontchaillou [Rennes], Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
viral reservoir
MESH: Humans MESH: CD4 Lymphocyte Count CD4:CD8 ratio MESH: HIV Infections / drug therapy CD4 lymphocyte count MESH: Adult women's health MESH: Male MESH: Anti-HIV Agents / therapeutic use MESH: Leukocytes Mononuclear MESH: Sex Factors [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases MESH: HIV-1 / immunology treatment outcome [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases MESH: Longitudinal Studies MESH: Viral Load MESH: Cohort Studies MESH: Female HIV infections MESH: Treatment Outcome |
| Zdroj: | Journal of the International AIDS Society Journal of the International AIDS Society, 2020, 23 (4), pp.e25485. ⟨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.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 |
| Externí odkaz: |
|