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
Abstract 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 patient...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-018-3198-2 |
| _version_ | 1819205660622979072 |
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| author | Eugenia Quiros-Roldan Paola Magro Elena Raffetti Ilaria Izzo Alessandro Borghetti Francesca Lombardi Annalisa Saracino Franco Maggiolo Francesco Castelli for the MASTER Cohort |
| author_facet | Eugenia Quiros-Roldan Paola Magro Elena Raffetti Ilaria Izzo Alessandro Borghetti Francesca Lombardi Annalisa Saracino Franco Maggiolo Francesco Castelli for the MASTER Cohort |
| author_sort | Eugenia Quiros-Roldan |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-23T04:55:14Z |
| format | Article |
| id | doaj.art-201582ee80144f6282e1baeede089678 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-23T04:55:14Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-201582ee80144f6282e1baeede0896782022-12-21T17:59:21ZengBMCBMC Infectious Diseases1471-23342018-06-0118111110.1186/s12879-018-3198-2Biochemical and inflammatory modifications after switching to dual antiretroviral therapy in HIV-infected patients in Italy: a multicenter retrospective cohort study from 2007 to 2015Eugenia Quiros-Roldan0Paola Magro1Elena Raffetti2Ilaria Izzo3Alessandro Borghetti4Francesca Lombardi5Annalisa Saracino6Franco Maggiolo7Francesco Castelli8for the MASTER CohortDepartment of Clinical and Experimental Sciences, University of BresciaDepartment of Clinical and Experimental Sciences, University of BresciaDepartment of Public Health Sciences, Karolinska InstitutetInfectious and Tropical Diseases Unit, Spedali CiviliInstitute of Clinical Infectious Diseases, Catholic University of Sacred HeartInstitute of Clinical Infectious Diseases, Catholic University of Sacred HeartClinic of Infectious Diseases, University Hospital PoliclinicoDivision of Infectious Diseases, AO Giovanni XXIIIDepartment of Clinical and Experimental Sciences, University of BresciaAbstract 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.http://link.springer.com/article/10.1186/s12879-018-3198-2HIVSwitchDual-therapyInflammationAntiretroviral therapy |
| spellingShingle | Eugenia Quiros-Roldan Paola Magro Elena Raffetti Ilaria Izzo Alessandro Borghetti Francesca Lombardi Annalisa Saracino Franco Maggiolo Francesco Castelli for the MASTER Cohort 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 BMC Infectious Diseases HIV Switch Dual-therapy Inflammation Antiretroviral therapy |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | HIV Switch Dual-therapy Inflammation Antiretroviral therapy |
| url | http://link.springer.com/article/10.1186/s12879-018-3198-2 |
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