Similar CD4/CD8 Ratio Recovery After Initiation of Dolutegravir Plus Lamivudine Versus Dolutegravir or Bictegravir-Based Three-Drug Regimens in Naive Adults With HIV

Frontiers in Immunology

Sonia Calzado Isbert¹  Javier Martínez-Sanz⁴  Raquel Ron⁴  Sergio Serrano-Villar⁴  Matilde Sánchez-Conde⁴  Luis Fernando López Cortés⁵  Juan Antonio Pineda⁶  Elena Moreno⁷  José Ramón Blanco⁸  Álvaro Mena⁹  Santiago Moreno^1,10  Alfonso Muriel^1,10 

[1]0Department of Infectious Diseases, Corporació Sanitària Parc Taulí, Sabadell, Spain

[2]Biostatistics Unit, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

[3]CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain

[4]CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain

[5]Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen del Rocío, Sevilla, Spain

[6]Department of Infectious Diseases and Clinical Microbiology, Hospital Universitario Nuestra Señora de Valme, Sevilla, Spain

[7]Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

[8]Hospital San Pedro, Centro de Investigación Biomédica de la Rioja (CIBIR), Logroño, Spain

[9]Infectious Diseases Unit, Internal Medicine Service, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain

[10]University of Alcalá, Madrid, Spain

关键词: HIV;    antiretroviral therapy;    dual therapy;    CD4/CD8 ratio;    integrase inhibitors;   

DOI  :  10.3389/fimmu.2022.873408

来源: DOAJ

【 摘 要 】

BackgroundThe initiation of antiretroviral treatment based on a 2-drug regimen (2DR) with dolutegravir plus lamivudine has demonstrated non-inferior efficacy than dolutegravir-based three-drug regimens (3DR). We aimed to assess whether the treatment initiation with this 2DR has a different impact on the CD4/CD8 ratio recovery than INSTI-based 3DR.MethodsWe emulated a target trial using observational data from the Spanish HIV Research Network cohort (CoRIS). The outcomes of interest were the normalization of the CD4/CD8 ratio at 48 weeks using three different cutoffs: 0.5, 1.0, and 1.5. We matched each participant who started 2DR with up to four participants who received 3DR. Subsequently, we fitted generalized estimating equation (GEE) models and used the Kaplan–Meier method for survival curves.ResultsWe included 485, 805, and 924 participants for cutoffs of 0.5, 1.0, and 1.5, respectively. At 48 weeks, 45% of participants achieved a CD4/CD8 ratio >0.5, 15% achieved a ratio >1.0, and 6% achieved a ratio >1.5. GEE models yielded a similar risk of reaching a CD4/CD8 ratio >0.5 (OR 1.00, 95% CI 0.67 - 1.50), CD4/CD8 >1.0 (OR 1.03, 95% CI 0.68 - 1.58), and CD4/CD8 >1.5 (OR 0.86, 95% CI 0.48 - 1.54) between both treatment strategies. There were no differences between 2DR and 3DR in the incidence ratio of CD4/CD8 ratio normalization at 0.5, 1.0 and 1.5 cut-offs.ConclusionsIn this large cohort study in people with HIV, ART initiation with dolutegravir plus lamivudine vs. dolutegravir or bictegravir-based triple antiretroviral therapy showed no difference in the rates of CD4/CD8 normalization at 48 weeks.

【 授权许可】

Unknown