1
|
Han WM, Avihingsanon A, Rajasuriar R, Tanuma J, Mundhe S, Lee MP, Choi JY, Pujari S, Chan YJ, Somia A, Zhang F, Kumarasamy N, NG OT, Gani Y, Chaiwarith R, Pham TN, Do CD, Ditangco R, Kiertiburanakul S, Khol V, Ross J, Jiamsakul A. CD4/CD8 Ratio Recovery Among People Living With HIV Starting With First-Line Integrase Strand Transfer Inhibitors: A Prospective Regional Cohort Analysis. J Acquir Immune Defic Syndr 2023; 92:180-188. [PMID: 36625858 PMCID: PMC10064076 DOI: 10.1097/qai.0000000000003121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/03/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND We evaluated trends in CD4/CD8 ratio among people living with HIV (PLWH) starting antiretroviral therapy (ART) with first-line integrase strand transfer inhibitors (INSTI) compared with non-INSTI-based ART, and the incidence of CD4/CD8 ratio normalization. METHODS All PLWH enrolled in adult HIV cohorts of IeDEA Asia-Pacific who started with triple-ART with at least 1 CD4, CD8 (3-month window), and HIV-1 RNA measurement post-ART were included. CD4/CD8 ratio normalization was defined as a ratio ≥1. Longitudinal changes in CD4/CD8 ratio were analyzed by linear mixed model, the incidence of the normalization by Cox regression, and the differences in ratio recovery by group-based trajectory modeling. RESULTS A total of 5529 PLWH were included; 80% male, median age 35 years (interquartile range [IQR], 29-43). First-line regimens were comprised of 65% NNRTI, 19% PI, and 16% INSTI. The baseline CD4/CD8 ratio was 0.19 (IQR, 0.09-0.33). PLWH starting with NNRTI- (P = 0.005) or PI-based ART (P = 0.030) had lower CD4/CD8 recovery over 5 years compared with INSTI. During 24,304 person-years of follow-up, 32% had CD4/CD8 ratio normalization. After adjusting for age, sex, baseline CD4, HIV-1 RNA, HCV, and year of ART initiation, PLWH started with INSTI had higher odds of achieving CD4/CD8 ratio normalization than NNRTI- (P < 0.001) or PI-based ART (P = 0.015). In group-based trajectory modeling analysis, INSTI was associated with greater odds of being in the higher ratio trajectory. CONCLUSIONS INSTI use was associated with higher rates of CD4/CD8 ratio recovery and normalization in our cohort. These results emphasize the relative benefits of INSTI-based ART for immune restoration.
Collapse
Affiliation(s)
- Win Min Han
- The Kirby Institute, UNSW Sydney, NSW, Australia
- HIV-NAT/ Thai Red Cross AIDS Research Centre and Centre of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Anchalee Avihingsanon
- HIV-NAT/ Thai Red Cross AIDS Research Centre and Centre of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Reena Rajasuriar
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Junko Tanuma
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Sanjay Mundhe
- BJ Government Medical College and Sassoon General Hospital, Pune, India
| | | | - Jun Yong Choi
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | | | - Yu-Jiun Chan
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Agus Somia
- Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
| | - Fujie Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | | | - Oon Tek NG
- Tan Tock Seng Hospital, National Centre for Infectious Diseases, Singapore
| | - Yasmin Gani
- Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | - Romanee Chaiwarith
- Chiang Mai University - Research Institute for Health Sciences, Chiang Mai, Thailand
| | | | | | - Rossana Ditangco
- Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | | | - Vohith Khol
- National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia
| | - Jeremy Ross
- TREAT Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | | | | |
Collapse
|
2
|
Jiamsakul A, Yunihastuti E, Van Nguyen K, Merati TP, Do CD, Ditangco R, Ponnampalavanar S, Zhang F, Kiertiburanakul S, Lee MP, Avihingasanon A, NG OT, Sim BLH, Wong W, Ross J, Law M. Mortality following diagnosis of tuberculosis in HIV-infected patients in Asia. HIV Med 2018; 19:10.1111/hiv.12621. [PMID: 29683253 PMCID: PMC6201296 DOI: 10.1111/hiv.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Evy Yunihastuti
- Working Group on AIDS, Faculty of Medicine, University of Indonesia/ Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | | | | | | | | | - Fujie Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | | | - Man-Po Lee
- Queen Elizabeth Hospital, Hong Kong, China
| | - Anchalee Avihingasanon
- HIV-NAT, The Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Oon Tek NG
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
| | | | - Wingwai Wong
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jeremy Ross
- TREAT Asia, amfAR – The Foundation for AIDS Research, Bangkok, Thailand
| | - Matthew Law
- The Kirby Institute, UNSW Sydney, NSW, Australia
| |
Collapse
|