Immunological Efficacy and the Impact on Weight of Dolutegravir-Based Regimen in Antiretroviral Therapy (ART)-Naïve Patients with HIV Infection.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-11-07 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S484703

Mingli Zhong, Xiang Zhang, Hongjing Guan, Chen Chen, Rentian Cai, Mingxue Qi, Yifan Su, Yingying Yang, Xinglian Xu, Cong Cheng, Hongxia Wei

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引用次数: 0

Abstract

Purpose: This study aimed to assess the immunological efficacy and the impact on weight of dolutegravir (DTG)-based antiretroviral therapy (ART) regimen in ART-naive people living with HIV (PLWH).

Methods: A prospective study was conducted on ART-naïve PLWH who treated with DTG-based or efavirenz (EFV)-based regimens in The Second Hospital of Nanjing. Based on previous studies, the sample size was 332 patients calculated by PASS software. Considering a 20% dropout rate, the expected sample size was 416 patients, which were 208 patients in the DTG and EFV groups, respectively.

Results: Among 416 enrolled participants, the median age was 30.0 years (25.0-43.0), 388 (93.3%) males. At baseline, patients in the DTG group had worse pre-treatment immune level, but with no significant difference in weight compared to the EFV group. After 12 months of follow-up, the CD4+ T-cell counts increased greater in the DTG group (P=0.036), while the CD4+/CD8+ T-cell ratio increased greater in the EFV group (P=0.014). There was no significant difference in the normalization of various immune indicators between the two groups. The weight gain of patients in the DTG group at different follow-up points was all significantly higher than that in the EFV group (P<0.05). Multivariate logistic regression analysis showed that DTG-based regimens (OR=4.524, 95% CI: 2.371-8.634, P<0.001), baseline VL ≥10^5 copies/mL (OR=2.563, 95% CI: 1.411-4.657, P=0.002), and baseline CD4+ T-cell counts <200 cells/μL (OR=2.595, 95% CI: 1.430-4.709, P=0.002) were risk factors for weight gain ≥5 kg during the 12-month follow-up period.

Conclusion: After 12 months of follow-up, the increase in CD4+ T-cell counts was higher in the DTG group than in the EFV group, but the overall immunological efficacy was similar in both groups. However, attention should be paid to patients' weight, especially in patients with high baseline viral load and low CD4+ T-cell counts who were treated with the DTG-based regimen.

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抗逆转录病毒疗法（ART）无效的艾滋病病毒感染者使用多罗替拉韦治疗方案的免疫学疗效及其对体重的影响

目的：本研究旨在评估基于多鲁替拉韦（DTG）的抗逆转录病毒疗法（ART）方案在ART-naive HIV感染者（PLWH）中的免疫学疗效及对体重的影响：南京市第二医院对接受基于DTG或依非韦伦（EFV）的抗逆转录病毒治疗方案的艾滋病病毒感染者进行了前瞻性研究。根据以往的研究，经PASS软件计算，样本量为332例患者。考虑到20%的辍学率，预计样本量为416人，其中DTG组和EFV组分别为208人：在 416 名注册参与者中，中位年龄为 30.0 岁（25.0-43.0），男性 388 人（93.3%）。基线时，DTG组患者治疗前的免疫水平较低，但体重与EFV组相比无显著差异。随访12个月后，DTG组的CD4+ T细胞计数增加较多（P=0.036），而EFV组的CD4+/CD8+ T细胞比率增加较多（P=0.014）。两组在各种免疫指标的正常化方面没有明显差异。DTG组患者在不同随访点的体重增加均显著高于EFV组（PPP=0.002），基线CD4+ T细胞计数P=0.002）是随访12个月期间体重增加≥5 kg的危险因素：随访12个月后，DTG组CD4+ T细胞计数的增加高于EFV组，但两组的总体免疫疗效相似。但应注意患者的体重，尤其是基线病毒载量高、CD4+ T细胞计数低且接受DTG方案治疗的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.