Immune Activation in HIV-Infected Patients Treated with Different ARV Regimens

Alessia Uglietti, Sergio Lo Caputo, Marinella Lauriola, Michele De Gennaro, Elisabetta Chiesa, Massimo Coen, Roberta Terzi, Dorothy H. Bray, Renato Maserati, Daria Trabattoni, Mario Clerici

Departments of Infectious Diseases of the Campo di Marte Hospital, Milano, Italy.
Departments of Infectious Diseases of the Chair of Immunology, University of Milano, Milano, Italy.
Departments of Infectious Diseases of the Chair of Immunology, University of Milano, Milano, Italy; Departments of Infectious Diseases of the Fondazione Don C. Gnocchi, Scientific Institute for Patient Care and Research, Milano, Italy.
Departments of Infectious Diseases of the Foundation IRCCS Policlinico San Matteo Hospital, Milano, Italy.
Departments of Infectious Diseases of the Immunoclin Ltd., Paris, France, Milano, Italy.
Departments of Infectious Diseases of the Luigi Sacco Hospital, Milano, Italy.
Departments of Infectious Diseases of the Santa Maria Annunziata Hospital, Milano, Italy.

DOI: 10.4236/wja.2012.22013                

Abstract

Objectives: To evaluate the effects of starting therapy with either Truvada (TVD) or Combivir (CBV) in combination with Efavirenz (EFV) or a boosted Protease Inhibitor (LPV/r, ATV/r, fAPV/r and SQV/r) on clinical, immunological, and virological parameters in HIV-infected antiretroviral (ARV) naive patients. Methods: Twenty-seven patients were prospectively enrolled and received TVD-EFV, 32 TVD-PI/r, 24 CBV-EFV, and 23 CBV-PI/r. Immunovirological analyses were performed at baseline and after 3, 6, 9 and 12 months after initiation of therapy; a full set of data is available for 51 patients. Results: Median CD4+ cell counts and HIV-RNA plasma viremia were comparable in the four groups of patients (TVD-EFV, TVD-PI/r, CBV-EFV, CBV-PI/r) at baseline. At month 12 HIV RNA plasma viremia was <50 cps/ml in all patients. Median CD4 cell counts increases were higher, although not significantly, in CBV-EFV and TVD-EFV patients. Finally, CD8+/CD38+/CDRO+T lymphocytes were significantly decreased after 12 months of therapy in all patients with, possibly, a faster effect seen in the EFV groups. Conclusions: Immunologic parameters are similarly affected by different ARV combinations, even if EFV-associated immunomodulation might be marginally better.

Keywords

HIV; Immune Activation; Antiretroviral Therapy

Conflicts of Interest

The authors declare no conflicts of interest.

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