Şahin Ezgi Aysu, Mavi Deniz, Kara Emre, Sönmezer Meliha Çağla, İnkaya Ahmet Çağkan, Ünal Serhat
Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Faculty of Pharmacy, Department of Clinical Pharmacy, Hacettepe University, Ankara, Turkey.
Postgrad Med. 2022 Aug;134(6):635-640. doi: 10.1080/00325481.2022.2085931. Epub 2022 Jun 7.
Despite the advances in antiretroviral treatment (ART), persistent inflammation remained a challenge. We analyzed the inflammatory-score changes through 2-years in people living with HIV (PLWH) treated with different antiretroviral regimes.
This study was conducted in Hacettepe University HIV/AIDS Treatment and Research Center. PLWH diagnosed between 2014 and 2020 were included. Inflammatory and metabolic markers (CD4/CD8 ratio, C-reactive protein (CRP), Systemic Inflammatory Index (SII), Neutrophil-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV), Platecrite (PCT), and Low-Density Lipoprotein/High-Density Lipoprotein (LDL/HDL), Platelet-to-Lymphocyte Ratio (PLR) and ARTs were captured from database through 2-years from the diagnosis. The 2-year change (Δ) in markers was calculated and compared by ART type (backbone and 3rd agent). Mann-Whitney-U test and T-test were used for statistical analysis.
This study included 205 PLWH; 175 (85.4%) were male, and the mean age was 38.98 (±10.88) years. The number of PLWH with suppressed viremia (<40 HIV-RNA copies/ml) was 164 (80%) at the end of the second year. MPV increased significantly higher among PLWH receiving ABC/3TC compared to PLWH receiving TDF/FTC (p < 0.05). The CD4:CD8 ratio increased, and SII, NLR, LDL/HDL ratios decreased significantly among PLWH treated with integrase strand transfer inhibitors (INSTI) compared with protease inhibitors (PI) and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) (p < 0.05).
Integrase inhibitor treatment is related to favorable inflammatory marker profile among PLWH in the 2-year follow-up. A favorable inflammatory profile may, in turn, contribute to the prevention of non-communicable diseases (NCD) among PLWH. This study showed that simple, easy-to-calculate markers could be implemented to define ongoing inflammation among PLWH under suppressive ART.
尽管抗逆转录病毒治疗(ART)取得了进展,但持续性炎症仍然是一个挑战。我们分析了接受不同抗逆转录病毒治疗方案的HIV感染者(PLWH)在两年内炎症评分的变化。
本研究在哈杰泰佩大学HIV/AIDS治疗与研究中心进行。纳入了2014年至2020年间确诊的PLWH。从诊断后的两年数据库中获取炎症和代谢标志物(CD4/CD8比值、C反应蛋白(CRP)、全身炎症指数(SII)、中性粒细胞与淋巴细胞比值(NLR)、平均血小板体积(MPV)、血小板压积(PCT)以及低密度脂蛋白/高密度脂蛋白(LDL/HDL)、血小板与淋巴细胞比值(PLR))和抗逆转录病毒治疗情况。计算标志物的两年变化(Δ),并按抗逆转录病毒治疗类型(主干药物和第三种药物)进行比较。采用曼-惠特尼U检验和T检验进行统计分析。
本研究纳入了205名PLWH;175名(85.4%)为男性,平均年龄为38.98(±10.88)岁。在第二年年底,病毒血症得到抑制(HIV-RNA拷贝数/ml<40)的PLWH有164名(80%)。与接受替诺福韦酯/恩曲他滨(TDF/FTC)的PLWH相比,接受阿巴卡韦/拉米夫定(ABC/3TC)的PLWH中MPV显著升高(p<0.05)。与蛋白酶抑制剂(PI)和非核苷类逆转录酶抑制剂(NNRTIs)相比,接受整合酶链转移抑制剂(INSTI)治疗的PLWH中CD4:CD8比值升高,SII、NLR、LDL/HDL比值显著降低(p<0.05)。
在两年的随访中,整合酶抑制剂治疗与PLWH中良好的炎症标志物谱相关。良好的炎症谱反过来可能有助于预防PLWH中的非传染性疾病(NCD)。本研究表明,可以采用简单、易于计算的标志物来定义接受抑制性抗逆转录病毒治疗的PLWH中的持续炎症。