Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients
Background: HIV-induced systemic immune activation and inflammation have been associated with morbidity and mortality in virologically suppressed patients. Objective: To evaluate the impact of treatment switch from a dual regimen with lamivudine (3TC) plus ritonavir-boosted protease inhibitors (PI/r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-05-01
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| Series: | HIV Research & Clinical Practice |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/25787489.2019.1653512 |
| _version_ | 1797661095503069184 |
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| author | Francesca Lombardi Simone Belmonti Alberto Borghetti Arturo Ciccullo Gianmaria Baldin Roberto Cauda Massimiliano Fabbiani Simona Di Giambenedetto |
| author_facet | Francesca Lombardi Simone Belmonti Alberto Borghetti Arturo Ciccullo Gianmaria Baldin Roberto Cauda Massimiliano Fabbiani Simona Di Giambenedetto |
| author_sort | Francesca Lombardi |
| collection | DOAJ |
| description | Background: HIV-induced systemic immune activation and inflammation have been associated with morbidity and mortality in virologically suppressed patients. Objective: To evaluate the impact of treatment switch from a dual regimen with lamivudine (3TC) plus ritonavir-boosted protease inhibitors (PI/r) to 3TC plus dolutegravir (DTG) on the monocyte activation marker soluble CD14 (sCD14) and other inflammatory biomarkers, interleukin-6 (IL-6), C-reactive protein (CRP), intestinal fatty acid–binding protein (I-FABP) and D-dimer. Methods: We performed a retrospective case-crossover study on integrase inhibitors-naïve virologically suppressed patients while on 3TC + PI/r dual maintenance therapy for ≥48 weeks who switched to 3TC + DTG and maintained this regimen for ≥48 weeks. Biomarkers plasma levels were tested by ELISA assays on stored samples at three time points: at switch (BL), 48 weeks before (−48 W) and 48 weeks after switch (+48 W). Results: A total of 67 patients were included. Median sCD14 levels were stable from −48 W to BL (from 6.07 to 6.04 log10 pg/mL, p = 0.235) but showed a statistically significant decrease after switch: from 6.04 (IQR 5.92-6.12) at BL to 5.95 (IQR 5.84–6.07) log10 pg/mL at + W48 (p < 0.001). Concurrently, an improvement in lipid profile was observed, even thought it was not correlated to the change in sCD14. The levels of IL-6, CRP, I-FABP and D-dimer remained stable before and after the switch to 3TC + DTG. Conclusions: In virologically suppressed HIV-infected patients on a 3TC + PI/r dual therapy, switching to 3TC + DTG was associated with a significant decline in sCD14. These data suggest reduced monocyte activation following substitution of boosted PI with DTG, which could have important clinical implications. |
| first_indexed | 2024-03-11T18:39:26Z |
| format | Article |
| id | doaj.art-09175815d34d469887db02420215df9d |
| institution | Directory Open Access Journal |
| issn | 2578-7470 |
| language | English |
| last_indexed | 2024-03-11T18:39:26Z |
| publishDate | 2019-05-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | HIV Research & Clinical Practice |
| spelling | doaj.art-09175815d34d469887db02420215df9d2023-10-12T13:43:52ZengTaylor & Francis GroupHIV Research & Clinical Practice2578-74702019-05-01203929810.1080/25787489.2019.16535121653512Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patientsFrancesca Lombardi0Simone Belmonti1Alberto Borghetti2Arturo Ciccullo3Gianmaria Baldin4Roberto Cauda5Massimiliano Fabbiani6Simona Di Giambenedetto7Università Cattolica del Sacro CuoreUniversità Cattolica del Sacro CuoreFondazione Policlinico Universitario A. Gemelli IRCCSUniversità Cattolica del Sacro CuoreUniversità Cattolica del Sacro CuoreUniversità Cattolica del Sacro CuoreFondazione IRCCS Policlinico San MatteoUniversità Cattolica del Sacro CuoreBackground: HIV-induced systemic immune activation and inflammation have been associated with morbidity and mortality in virologically suppressed patients. Objective: To evaluate the impact of treatment switch from a dual regimen with lamivudine (3TC) plus ritonavir-boosted protease inhibitors (PI/r) to 3TC plus dolutegravir (DTG) on the monocyte activation marker soluble CD14 (sCD14) and other inflammatory biomarkers, interleukin-6 (IL-6), C-reactive protein (CRP), intestinal fatty acid–binding protein (I-FABP) and D-dimer. Methods: We performed a retrospective case-crossover study on integrase inhibitors-naïve virologically suppressed patients while on 3TC + PI/r dual maintenance therapy for ≥48 weeks who switched to 3TC + DTG and maintained this regimen for ≥48 weeks. Biomarkers plasma levels were tested by ELISA assays on stored samples at three time points: at switch (BL), 48 weeks before (−48 W) and 48 weeks after switch (+48 W). Results: A total of 67 patients were included. Median sCD14 levels were stable from −48 W to BL (from 6.07 to 6.04 log10 pg/mL, p = 0.235) but showed a statistically significant decrease after switch: from 6.04 (IQR 5.92-6.12) at BL to 5.95 (IQR 5.84–6.07) log10 pg/mL at + W48 (p < 0.001). Concurrently, an improvement in lipid profile was observed, even thought it was not correlated to the change in sCD14. The levels of IL-6, CRP, I-FABP and D-dimer remained stable before and after the switch to 3TC + DTG. Conclusions: In virologically suppressed HIV-infected patients on a 3TC + PI/r dual therapy, switching to 3TC + DTG was associated with a significant decline in sCD14. These data suggest reduced monocyte activation following substitution of boosted PI with DTG, which could have important clinical implications.http://dx.doi.org/10.1080/25787489.2019.1653512hivinflammationinflammatory biomarkersdual therapydolutegravirscd14 |
| spellingShingle | Francesca Lombardi Simone Belmonti Alberto Borghetti Arturo Ciccullo Gianmaria Baldin Roberto Cauda Massimiliano Fabbiani Simona Di Giambenedetto Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients HIV Research & Clinical Practice hiv inflammation inflammatory biomarkers dual therapy dolutegravir scd14 |
| title | Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients |
| title_full | Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients |
| title_fullStr | Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients |
| title_full_unstemmed | Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients |
| title_short | Reduced soluble CD14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed HIV-infected patients |
| title_sort | reduced soluble cd14 levels after switching from a dual regimen with lamivudine plus boosted protease inhibitors to lamivudine plus dolutegravir in virologically suppressed hiv infected patients |
| topic | hiv inflammation inflammatory biomarkers dual therapy dolutegravir scd14 |
| url | http://dx.doi.org/10.1080/25787489.2019.1653512 |
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