학술논문
Comparison of Integrase Strand Transfer Inhibitors (INSTIs) and Protease-Boosted Inhibitors (PIs) on the Reduction in Chronic Immune Activation in a Virally Suppressed, Mainly Male Population Living with HIV (PLWH).
Document Type
Academic Journal
Author
Nitsotolis T; 3rd Department of Internal Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.; Kyriakoulis KG; 3rd Department of Internal Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.; Kollias A; 3rd Department of Internal Medicine, School of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.; Papalexandrou A; Nephrological Center 'Frontis' of Piraeus, 18757 Piraeus, Greece.; Kalampoka H; Department of Clinical Biochemistry, University General Hospital 'ATTIKO', National and Kapodistrian University of Athens Medical School, 12462 Athens, Greece.; Mastrogianni E; 1st Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece.; Basoulis D; 1st Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece.; Psichogiou M; 1st Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece.
Source
Publisher: MDPI Country of Publication: Switzerland NLM ID: 9425208 Publication Model: Electronic Cited Medium: Internet ISSN: 1648-9144 (Electronic) Linking ISSN: 1010660X NLM ISO Abbreviation: Medicina (Kaunas) Subsets: MEDLINE
Subject
Language
English
Abstract
Background and Objectives: The success of combined antiretroviral therapy (cART) has led to a dramatic improvement in the life expectancy of people living with HIV (PLWH). However, there has been an observed increase in cardiometabolic, bone, renal, hepatic, and neurocognitive manifestations, as well as neoplasms, known as serious non-AIDS events/SNAEs, compared to the general population of corresponding age. This increase is linked to a harmful phenomenon called inflammaging/immunosenescence, which is driven by chronic immune activation and intestinal bacterial translocation. In this study, we examined immunological and metabolic parameters in individuals receiving current cART. Materials and Methods: The study was conducted at Laiko General Hospital in Athens, Greece. Plasma concentrations of sCD14, IL-6, SuPAR, I-FABP, and LBP were measured in virally suppressed PLWH under cART with at least 350 CD4 lymphocytes/μL. We compared these levels between PLWH receiving integrase strand transfer inhibitors (INSTIs) and protease inhibitors (PIs) and attempted to correlate them with chronic immune activation and metabolic parameters. Results: Data from 28 PLWH were analyzed, with a mean age of 52 and 93% being males. Among the two comparison groups, IL-6 levels were higher in the PIs group (5.65 vs. 7.11 pg/mL, p = 0.03). No statistically significant differences were found in the other measured parameters. A greater proportion of PLWH under INSTIs had normal-range LBP (33% vs. 0%, p = 0.04). When using inverse probability of treatment weighting, no statistically significant differences in the measured parameters were found between the two groups (sCD14 p = 0.511, IL-6 p = 0.383, SuPAR p = 0.793, I-FABP p = 0.868, and LBP p = 0.663). Glucose levels were found to increase after viral suppression in the entire sample (92 mg/dL vs. 98 mg/dL, p = 0.009). Total (191 mg/dL vs. 222 mg/dL, p = 0.005) and LDL cholesterol (104 mg/dL vs. 140 mg/dL, p = 0.002) levels were higher in the PIs group. No significant differences were observed in liver and renal function tests. Conclusions: Further investigation is warranted for PLWH on cART-containing INSTI regimens to explore potential reductions in chronic immune activation and intestinal bacterial translocation.