Infectious Diseases Unit, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.
Department of Health Sciences (DiSSal), University of Genova, 16132 Genova, Italy.
Viruses. 2022 Oct 22;14(11):2315. doi: 10.3390/v14112315.
The aim of the present study was to evaluate CD4/CD8 dynamics in patients on dolutegravir (DTG)-based two-drug regimens (2DRs) and compare them with DTG-containing triple-drug regimens (3DRs). A prospective observational study was performed in the context of the SCOLTA cohort. Experienced PWH with HIV-RNA < 50 copies/mL were included if they were on the DTG-2DR, the DTG + tenofovir/emtricitabine (TDF/FTC) regimen, the DTG + tenofovir alafenamide (TAF)/FTC regimen, or the DTG + abacavir/lamivudine (ABC/3TC) regimen; they were followed-up for at least one year. A total of 533 PWH were enrolled, 120 in the DTG + 3TC group, 38 in the DTG + protease inhibitors (PI) group, 67 in the DTG + rilpivirine (RPV) group, 49 in the DTG + TDF/FTC group, 27 in the DTG + TAF/FTC group, and 232 in the DTG + ABC/3TC group. After one year, the CD4/CD8 ratio significantly increased in the PWH treated with DTG + 3TC (+0.08 ± 0.26), DTG + TDF/FTC (+0.1 ± 0.19), and DTG + ABC/3TC (+0.08 ± 0.25). At two years, the CD4/CD8 increase was confirmed for PWH on DTG + TDF/FTC (+0.16 ± 0.28) and DTG + ABC/3TC (+0.1 ± 0.3). In the SCOLTA cohort, PWH on 2DRs experienced a CD4/CD8 increase only in the DTG + 3TC group. Controlled studies with longer follow-up will clarify the long-term immunological and clinical impacts of DTG-2DR.
本研究旨在评估接受多替拉韦(DTG)二联疗法(2DR)和包含 DTG 的三联疗法(3DR)的患者的 CD4/CD8 动力学,并对其进行比较。在 SCOLTA 队列研究中进行了一项前瞻性观察性研究。如果经验丰富的 HIV RNA<50 拷贝/ml 的 HIV 感染者正在接受 DTG-2DR、DTG+替诺福韦/恩曲他滨(TDF/FTC)方案、DTG+替诺福韦艾拉酚胺(TAF/FTC)方案或 DTG+阿巴卡韦/拉米夫定(ABC/3TC)方案,则将其纳入本研究,并至少随访一年。共有 533 名 HIV 感染者入组,其中 120 名在 DTG+3TC 组,38 名在 DTG+蛋白酶抑制剂(PI)组,67 名在 DTG+利匹韦林(RPV)组,49 名在 DTG+TDF/FTC 组,27 名在 DTG+TAF/FTC 组,232 名在 DTG+ABC/3TC 组。一年后,DTG+3TC(+0.08±0.26)、DTG+TDF/FTC(+0.1±0.19)和 DTG+ABC/3TC(+0.08±0.25)治疗的 HIV 感染者的 CD4/CD8 比值显著增加。两年后,DTG+TDF/FTC(+0.16±0.28)和 DTG+ABC/3TC(+0.1±0.3)治疗的 HIV 感染者的 CD4/CD8 增加得到确认。在 SCOLTA 队列中,只有在 DTG+3TC 组的 HIV 感染者在接受 2DR 治疗后才出现 CD4/CD8 增加。具有更长随访时间的对照研究将阐明 DTG-2DR 的长期免疫和临床影响。