Han, Win Min and Avihingsanon, Anchalee and Rajasuriar, Reena and Tanuma, Junko and Mundhe, Sanjay and Lee, Man-Po and Choi, Jun Yong and Pujari, Sanjay and Chan, Yu-Jiun and Somia, Agus and Zhang, Fujie and Kumarasamy, Nagalingeswaran and Ng, Oon Tek and Gani, Yasmin and Chaiwarith, Romanee and Pham, Thach Ngoc and Do, Cuong Duy and Ditangco, Rossana and Kiertiburanakul, Sasisopin and Khol, Vohith and Ross, Jeremy and Jiamsakul, Awachana and Asia-Pacific, IeDEA (2023) CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis. Journal of Acquired Immune Deficiency Syndromes, 92 (2). pp. 180-188. ISSN 1525-4135, DOI https://doi.org/10.1097/QAI.0000000000003121.
Full text not available from this repository.Abstract
Background:We evaluated trends in CD4/CD8 ratio among people living with HIV (PLWH) starting antiretroviral therapy (ART) with first-line integrase strand transfer inhibitors (INSTI) compared with non-INSTI-based ART, and the incidence of CD4/CD8 ratio normalization.Methods:All PLWH enrolled in adult HIV cohorts of IeDEA Asia-Pacific who started with triple-ART with at least 1 CD4, CD8 (3-month window), and HIV-1 RNA measurement post-ART were included. CD4/CD8 ratio normalization was defined as a ratio >= 1. Longitudinal changes in CD4/CD8 ratio were analyzed by linear mixed model, the incidence of the normalization by Cox regression, and the differences in ratio recovery by group-based trajectory modeling.Results:A total of 5529 PLWH were included; 80% male, median age 35 years (interquartile range IQR], 29-43). First-line regimens were comprised of 65% NNRTI, 19% PI, and 16% INSTI. The baseline CD4/CD8 ratio was 0.19 (IQR, 0.09-0.33). PLWH starting with NNRTI- (P = 0.005) or PI-based ART (P = 0.030) had lower CD4/CD8 recovery over 5 years compared with INSTI. During 24,304 person-years of follow-up, 32% had CD4/CD8 ratio normalization. After adjusting for age, sex, baseline CD4, HIV-1 RNA, HCV, and year of ART initiation, PLWH started with INSTI had higher odds of achieving CD4/CD8 ratio normalization than NNRTI- (P < 0.001) or PI-based ART (P = 0.015). In group-based trajectory modeling analysis, INSTI was associated with greater odds of being in the higher ratio trajectory.Conclusions:INSTI use was associated with higher rates of CD4/CD8 ratio recovery and normalization in our cohort. These results emphasize the relative benefits of INSTI-based ART for immune restoration.
| Item Type: | Article |
|---|---|
| Funders: | United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Allergy & Infectious Diseases (NIAID), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Cancer Institute (NCI), United States Department of Health & Human Services National Institutes of Health (NIH) - USA NIH National Institute of Mental Health (NIMH) |
| Uncontrolled Keywords: | CD4; CD8 ratio; Immune dysfunction; Antiretroviral treatment; INSTI; Asia-Pacific |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Medicine Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 06 Jul 2023 03:01 |
| Last Modified: | 06 Jul 2023 03:01 |
| URI: | http://eprints.um.edu.my/id/eprint/38693 |
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