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- Title
CD4/CD8 Ratio Outcome According to the Class of the Third Active Drug in Antiretroviral Therapy Regimens: Results From the Quebec Human Immunodeficiency Virus Cohort Study.
- Authors
Sangaré, Mohamed N'dongo; Baril, Jean-Guy; Pokomandy, Alexandra de; Klein, Marina; Thomas, Réjean; Tremblay, Cécile; Pexos, Costa; Durand, Madeleine; Chawla, Seerat; Laporte, Louise; Trottier, Helen
- Abstract
Background The impact of different therapeutic classes of drugs in antiretroviral therapy (ART) regimens on the CD4/CD8 ratio is not well documented in people treated for HIV. The objective of this study was to analyze the long-term effect of exposure to integrase strand transfer inhibitor (INSTI) on CD4/CD8 ratio compared with nonnucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI) among ART-treated persons with HIV (PWH). Methods Data from the Quebec HIV Cohort collected from 31 August 2017 were used. Our analysis included all patients in the cohort who received a first or subsequent ART regimen composed of 2 nucleoside reverse transcriptase inhibitors (NRTIs) and a third active drug of a different class (NNRTI, PI, or INSTI) for at least 16 weeks. Marginal structural Cox models were constructed to estimate the effect of different therapeutic classes on the CD4/CD8 ratio outcome. Results Among the 3907 eligible patients, 972 (24.9%), 1996 (51.1%), and 939 (24.0%) were exposed to an ART regimen whose third active agent was an NNRTI, PI, or INSTI, respectively. The total follow-up time was 13 640.24 person-years. The weighted hazard ratio for the association between the third active class and CD4/CD8 ratio ≥1 was.56 (95% confidence interval [CI]:.48–.65) for patients exposed to NNRTI + 2 NRTIs and.41 (95% CI:.35–.47) for those exposed to PI + 2 NRTIs, compared with those exposed INSTI + 2 NRTIs. Conclusions For people treated for HIV, INSTI-based ART appears to be associated with a higher CD4/CD8 ratio than NNRTI and PI-based ART.
- Subjects
QUEBEC (Province); HIV infections; HIV integrase inhibitors; PROTEASE inhibitors; CONFIDENCE intervals; VIRAL load; REVERSE transcriptase inhibitors; ANTIRETROVIRAL agents; PROTEOLYTIC enzymes; HIGHLY active antiretroviral therapy; TREATMENT effectiveness; COMPARATIVE studies; CD4 lymphocyte count; IMMUNITY; DESCRIPTIVE statistics; RESEARCH funding; T cells; LONGITUDINAL method
- Publication
Clinical Infectious Diseases, 2023, Vol 76, Issue 11, p1879
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad056