Victoria Rios-Vazquez, Wilhelm A J W Vos, Marc J T Blaauw, Louise E Van Eekeren, Albert L Groenendijk, Adriana Navas, Nadira Vadaq, Leo A B Joosten, Mihai G Netea, Willem L Blok, Janneke E Stalenhoef, Lambert Van Den Heuvel, Andre J A M Van Der Ven, Jan Van Lunzen
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引用次数: 0
Abstract
Objective: To compare the systemic and immune effects of two-drug regimens (2DR) and three-drug regimens (3DR) in people with HIV (PWH).
Design: In a cross-sectional study, multiomics data were analyzed in dolutegravir (DTG) plus lamivudine (3TC) 2DR and 3DR comprising DTG with two nucleoside reverse transcriptase inhibitors (NRTIs).
Methods: Data from the 2000HIV cohort of virally suppressed PWH on combination antiretroviral treatment (cART) regimens were analyzed. Groups included DTG + 3TC ( n = 191), DTG + 3TC + abacavir (ABC) ( n = 188), and DTG + tenofovir disoproxil fumarate or tenofovir alafenamide (TDF/TAF) + emtricitabine (FTC) ( n = 115). Systemic functions were assessed via plasma protein profiling (Olink Explore, 2367 proteins), while peripheral blood mononuclear cells (PBMCs) were used to evaluate immune effects by analyzing Bulk RNA-Seq and ex-vivo cytokine production capacity.
Results: Plasma protein analysis revealed that 2DR associated to lower protein expression and pathways related to metabolism, stress responses, chemokine signaling, and immune responses compared to 3DR. Four proteins - CXCL8, DDC, PMM2, and EPS8L2 - were consistently downregulated in 2DR. Differential gene expression analysis identified 17 overlapping downregulated genes across all 3DR vs. 2DR comparisons, linked to chromatin structure, cellular senescence, stress response, and cytokine activity. Cytokine production was similar across 2DR and 3DR groups, except for enhanced interleukin (IL)-17 production in DTG + TDF + FTC users.
Conclusions: Reducing NRTIs in DTG-based 2DR, particularly by omitting ABC or TAF/TDF, suggests decreased activation of stress response and immune-related pathways. Importantly, the functional capacity of circulating immune cells remains largely unchanged between 2DR and 3DR.
期刊介绍：
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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