Artículo
Similar CD4/CD8 Ratio Recovery After Initiation of Dolutegravir Plus Lamivudine Versus Dolutegravir or Bictegravir-Based Three-Drug Regimens in Naive Adults With HIV
Autor/es | Martínez-Sanz, Javier
Ron, Raquel Moreno, Elena Sánchez-Conde, Matilde Muriel, Alfonso López Cortés, Luis Fernando Pineda Vergara, Juan Antonio Serrano-Villar, Sergio |
Departamento | Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2022 |
Fecha de depósito | 2022-11-08 |
Publicado en |
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Resumen | The initiation of antiretroviral treatment based on a 2-drug regimen (2DR) with
dolutegravir plus lamivudine has demonstrated non-inferior efficacy than dolutegravir-based
three-drug regimens (3DR). We aimed to assess ... The initiation of antiretroviral treatment based on a 2-drug regimen (2DR) with dolutegravir plus lamivudine has demonstrated non-inferior efficacy than dolutegravir-based three-drug regimens (3DR). We aimed to assess whether the treatment initiation with this 2DR has a different impact on the CD4/CD8 ratio recovery than INSTI-based 3DR. Methods: We emulated a target trial using observational data from the Spanish HIV Research Network cohort (CoRIS). The outcomes of interest were the normalization of the CD4/CD8 ratio at 48 weeks using three different cutoffs: 0.5, 1.0, and 1.5. We matched each participant who started 2DR with up to four participants who received 3DR. Subsequently, we fitted generalized estimating equation (GEE) models and used the Kaplan–Meier method for survival curves. Results: We included 485, 805, and 924 participants for cutoffs of 0.5, 1.0, and 1.5, respectively. At 48 weeks, 45% of participants achieved a CD4/CD8 ratio >0.5, 15% achieved a ratio >1.0, and 6% achieved a ratio >1.5. GEE models yielded a similar risk of reaching a CD4/CD8 ratio >0.5 (OR 1.00, 95% CI 0.67 - 1.50), CD4/CD8 >1.0 (OR 1.03, 95% CI 0.68 - 1.58), and CD4/CD8 >1.5 (OR 0.86, 95% CI 0.48 - 1.54) between both treatment strategies. There were no differences between 2DR and 3DR in the incidence ratio of CD4/CD8 ratio normalization at 0.5, 1.0 and 1.5 cut-offs. Conclusions: In this large cohort study in people with HIV, ART initiation with dolutegravir plus lamivudine vs. dolutegravir or bictegravir-based triple antiretroviral therapy showed no difference in the rates of CD4/CD8 normalization at 48 weeks. |
Agencias financiadoras | Red Temática de Investigación Cooperativa en Sida Instituto de Salud Carlos III European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER) |
Identificador del proyecto | RD06/006
RD12/0017/0018 RD16/ 0002/0006 AC17/00019 PI18/00154 COV20/00349 ICI20/00058 |
Cita | Martínez-Sanz, J., Ron, R., Moreno, E., Sánchez-Conde, M., Muriel, A., López Cortés, L.F.,...,Serrano-Villar, S. (2022). Similar CD4/CD8 Ratio Recovery After Initiation of Dolutegravir Plus Lamivudine Versus Dolutegravir or Bictegravir-Based Three-Drug Regimens in Naive Adults With HIV. Frontiers in Immunology, 13, 873408. https://doi.org/10.3389/fimmu.2022.873408. |
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