RT info:eu-repo/semantics/article
T1 Predict the effects of dolutegravir (DTG) plus lamivudine (3TC) on immunological responses in people living with HIV (PLWHIV)
A1 Troya, Jesús
A1 Pedrero Tomé, Roberto
A1 Buzón, Luis
A1 Dueñas Gutiérrez, Carlos Jesús
K1 HIV
K1 HIV infections
K1 VIH
K1 Infecciones por VIH
K1 AIDS (Disease)
K1 Sida
K1 Infectious diseases
K1 Immunology
K1 Medicine
K1 Public health
K1 Dolutegravir
K1 Lamivudine
K1 32 Ciencias Médicas
K1 3205.05 Enfermedades Infecciosas
K1 2412 Inmunología
K1 3212 Salud Publica
AB Background: Immune recovery in people living with HIV (PLWHIV) is a residual aspect of antiretroviral treatment (ART) in most patients, but in a non-negligible proportion of them, the CD4+ lymphocytes count, or CD4/CD8 ratio remains suboptimal. Methods: We performed a model of the immune response after 24 weeks of switching to a 2DR with DTG plus 3TC in a retrospective multicenter cohort of undetectable and experienced patients using significant predictor variables associated with the parameters or situations defined as success and failure. Clinical variables studied were CD4+ and CD8+ lymphocyte count, percentage of CD4, and CD4/CD8 ratio. These parameters were assessed at baseline and 24 weeks after the switch. Based on the evolution of each variable, four categories of immune response and four categories of non-immune response were defined. Immune response was defined as CD4+ count > 500 cells/mm3, %CD4 > 30%, CD8+ count < 1000 cells/mm3 and CD4/CD8 ratio ≥ 0.9. Non-response is just the opposite. Results: In our different models of immunological response, the presence of stage of AIDS (p = 0.035, p = 0.065) and current age over 50 years (p = 0.045) are postulated as statistically significative limiting factors in achieving an improvement in CD4, %CD4, CD8, and CD4/CD8 ratio. Late HIV diagnosis (p = 0.156), without statistical significance, enhanced late the previous variables. In contrast, conditions where patients start with CD4 > 500 cells/mm3 (p = 0.054); CD4 > 30% (p = 0.054, p = 0.084); CD8 < 1000 cells/mm3 (p = 0.018), and CD4/CD8 ≥ 0.9 (p = 0.013, p = 0.09) are detected as stimulating or conducive to DTG plus 3TC treatment success. Conclusion: These models represent a proof of concept that could become a valuable tool for clinicians to predict the effects of DTG plus 3TC on immunological responses prior to the switch in undetectable pre-treated PLWHIV with immune dysfunction. The main predictors for immunological failure were late HIV diagnosis, stage of AIDS, and current age over 50 years. In contrast, starting with a normalized immune status was detected as stimulating or conducive to DTG plus 3TC treatment success.
PB MDPI
SN 2077-0383
YR 2023
FD 2023
LK https://uvadoc.uva.es/handle/10324/63487
UL https://uvadoc.uva.es/handle/10324/63487
LA eng
NO Journal of Clinical Medicine, 2023, Vol. 12, Nº. 3, 1176
NO Producción Científica
DS UVaDOC
RD 24-nov-2024