Switching to dual antiretroviral regimens is associated with improvement or no changes in activation and inflammation markers in virologically suppressed HIV‐1‐infected patients: the TRILOBITHE pilot study

Switching to dual antiretroviral regimens is associated with improvement or no changes in activation and inflammation markers in virologically suppressed HIV‐1‐infected patients: the TRILOBITHE pilot study

Objectives While the use of dual antiretroviral therapies could reduce the toxicity of antiretroviral treatment in treatment‐experienced HIV‐1‐infected patients, it is crucial to know if reducing the number of drugs could lead to an adverse increase in inflammation and activation markers. Methods Th...

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Bibliographic Details
Published in:HIV medicine Vol. 20; no. 8; pp. 555 - 560
Main Authors: Vallejo, A, Molano, MdC, Monsalvo‐Hernando, M, Hernández‐Walias, F, Fontecha‐Ortega, M, Casado, JL
Format: Journal Article
Language:English
Published: England Wiley Subscription Services, Inc 01-09-2019
Subjects:
Activation
Anti-Retroviral Agents - pharmacology
Anti-Retroviral Agents - therapeutic use
Antiretroviral agents
Biomarkers
Biomarkers - blood
Blood coagulation
CD14 antigen
CD4 antigen
CD4 Lymphocyte Count
Cross-Sectional Studies
Demographics
Dimers
Drug Therapy, Combination
dual therapy
Female
HIV
HIV Infections - drug therapy
HIV Infections - immunology
HIV-1 - drug effects
HIV-1 - immunology
HIV‐1
Human immunodeficiency virus
Humans
Immune response
Immune system
Immunosuppressive agents
Inflammation
Interferon
Interleukins
Male
Middle Aged
Patients
Pilot Projects
Proteins
Spain
Switching
Tertiary Care Centers
Therapy
Toxicity
Tumor necrosis factor
Tumor necrosis factor-TNF
Tumors
Spain
HIV-1
immune response
biomarkers
dual therapy
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Summary:Objectives While the use of dual antiretroviral therapies could reduce the toxicity of antiretroviral treatment in treatment‐experienced HIV‐1‐infected patients, it is crucial to know if reducing the number of drugs could lead to an adverse increase in inflammation and activation markers. Methods This was a cross‐sectional pilot study conducted at the HIV‐1 Unit at the Tertiary University Hospital in Madrid, Spain, evaluating biomarkers of activation [interferon‐γ‐induced protein 10 (IP10), high‐sensitivity C‐reactive protein (hs‐CRP), soluble CD14 (sCD14) and sCD163], inflammation [interleukin‐6 (IL‐6)], blood coagulation (d‐dimer), and immune response [interferon (IFN)‐γ, tumour necrosis factor (TNF)‐α and IL‐4] in three groups of suppressed HIV‐1‐infected patients: patients continuing on triple therapy (26 patients), and patients who switched from triple to dual therapy, at 24 or 48 weeks after switching (13 and 36 patients, respectively). Results Demographic and immunovirological parameters were similar in the three groups of patients. IL‐6 and sCD14 levels were lower in patients at 48 weeks after switching to dual therapy compared with those found in patients who continued to receive triple therapy (P = 0.012 and P = 0.001, respectively), with no differences in the levels of the remaining biomarkers. Among patients with nadir CD4 count ≤ 200 cells/μL, sCD14 levels were lower in patients who had been on dual therapy for 48 weeks (14 patients) compared with those found in patients who received ongoing triple therapy (11 patients; P = 0.029), with no differences in the levels of the other biomarkers. Conclusions HIV‐1‐infected patients receiving dual regimens showed similar or even lower levels of inflammatory and activation markers compared with those found in patients who received ongoing triple therapy. Of note, similar data were obtained in patients with low nadir CD4 count.
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ISSN:1464-2662
1468-1293
DOI:10.1111/hiv.12749