Long-Term Changes of Inflammatory Biomarkers in Individuals on Suppressive Three-Drug or Two-Drug Antiretroviral Regimens
Por:
Serrano-Villar, S, Lopez-Huertas, M, Jimenez, D, Galera, C, Martinez-Sanz, J, Moreno, E, Muriel, A, Gutierez, F, Busca, C, Portilla, J, Bisbal, O, Iribarren, J, Tejerina, F, de los Santos, I, Moreno, S and CoRIS
Publicada:
14 mar 2022
Resumen:
BackgroundBecause inflammation is associated with mortality and has been linked to HIV transcription in lymphoid tissues during ART, it is necessary to address the long-term effects of switching 3-drug (3DR) to 2-drug regimens (2DR) on inflammation. MethodsNested study in the Spanish AIDS Research Network. We selected PWH ART-naive initiating 3DR who achieved viral suppression in the first 48 weeks and either remained on 3DR or switched to 2DR (3TC+bPI; 3TC+DTG; DTG+RPV). We assessed the trajectories on inflammatory markers during ART using multivariate piecewise mixed models. ResultsWe analyzed 619 plasma samples from 148 patients (3DR, N=90; 2DR, N=58), the median follow-up was 4.6 (IQR 3.2-6.2) years. There were no significant differences in baseline characteristics between groups. After adjusting for potential confounders, patients with 3DR experienced a slow decline of IL6, hs-CRP, sCD14, sCD163, and D-dimer over time. In contrast, compared to 3DR, switching to 2DR was associated with increases in IL-6 (p=0.001), hs-CRP (p=0.003), and D-dimer (p=0.001) after year 3 from virologic suppression. 2DR was associated with a higher risk of hs-CRP quartile increase (aOR 3.3, 95%CI 1.1-10) and D-dimer quartile increase (aOR 3.7, 95%CI 1.1-13). The adjusted biomarker trajectories did not reveal a distinct pattern according to the type of 2DR used (bPI vs DTG). ConclusionsIn this study in virally suppressed individuals, maintaining 3DR was associated with a more favorable long-term inflammatory profile than switching to 2DR. The potential clinical implications of these findings on the development of non-AIDS events deserve further investigation.
Filiaciones:
Serrano-Villar, S:
Univ Alcala prime, Inst Investivestigac Ramon Cajal IRYCIS, Hosp Univ Ramon & Cajal, Fac Med,Dept Infect Dis, Madrid, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Lopez-Huertas, M:
Inst Salud Carlos III, Ctr Nacl Microbiol, Madrid, Spain
Jimenez, D:
Univ Alcala prime, Inst Investivestigac Ramon Cajal IRYCIS, Hosp Univ Ramon & Cajal, Fac Med,Dept Infect Dis, Madrid, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Galera, C:
Hosp Univ Virgen Arrixaca, HIV Unit, Murcia, Spain
Martinez-Sanz, J:
Univ Alcala prime, Inst Investivestigac Ramon Cajal IRYCIS, Hosp Univ Ramon & Cajal, Fac Med,Dept Infect Dis, Madrid, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Moreno, E:
Univ Alcala prime, Inst Investivestigac Ramon Cajal IRYCIS, Hosp Univ Ramon & Cajal, Fac Med,Dept Infect Dis, Madrid, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Muriel, A:
Univ Alcala, Hosp Univ Ramon & Cajal, Fac Med, Biostatist Unit, Madrid, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
:
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Univ Miguel Hernandez, Alicante, Spain
Hosp Gen Univ Elche, Alicante, Spain
Busca, C:
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
Hosp Univ La Paz, HIV Unit, Madrid, Spain
Portilla, J:
Hosp Gen Univ Alicante, Dept Internal Med, Alicante, Spain
Bisbal, O:
Hosp Univ Doce Octubre, HIV Unit, Madrid, Spain
Iribarren, J:
Hosp Univ Donostia, HIV Unit, Donostia San Sebastian, Spain
Tejerina, F:
Hosp Univ Gregorio Maranon, HIV Unit, Madrid, Spain
de los Santos, I:
Hosp Univ Princesa, HIV Unit, Madrid, Spain
Moreno, S:
Univ Alcala prime, Inst Investivestigac Ramon Cajal IRYCIS, Hosp Univ Ramon & Cajal, Fac Med,Dept Infect Dis, Madrid, Spain
Inst Salud Carlos III, CIBER Enfermedades Infecciosas CIBER Infec, Madrid, Spain
gold, Green Published
|