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换用多替拉韦为基础的二联方案治疗 96 周后 CD4/CD8 T 细胞比值的变化轨迹:一项多中心前瞻性队列研究的结果。

Trajectories of CD4/CD8 T-Cells Ratio 96 Weeks after Switching to Dolutegravir-Based Two-Drug Regimens: Results from a Multicenter Prospective Cohort Study.

机构信息

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.

出版信息

Viruses. 2022 Oct 22;14(11):2315. doi: 10.3390/v14112315.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/702c/9696165/d408fa17aa98/viruses-14-02315-g001.jpg

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