Staff View: CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis

CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis

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 adul...

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Main Authors:	Han, Win Min, Avihingsanon, Anchalee, Rajasuriar, Reena, Tanuma, Junko, Mundhe, Sanjay, Lee, Man-Po, Choi, Jun Yong, Pujari, Sanjay, Chan, Yu-Jiun, Somia, Agus, Zhang, Fujie, Kumarasamy, Nagalingeswaran, Ng, Oon Tek, Gani, Yasmin, Chaiwarith, Romanee, Pham, Thach Ngoc, Do, Cuong Duy, Ditangco, Rossana, Kiertiburanakul, Sasisopin, Khol, Vohith, Ross, Jeremy, Jiamsakul, Awachana, Asia-Pacific, IeDEA
Format:	Article
Published:	Lippincott, Williams & Wilkins 2023
Subjects:	R Medicine
Online Access:	http://eprints.um.edu.my/38693/
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spelling	my.um.eprints.386932023-07-06T03:01:10Z http://eprints.um.edu.my/38693/ CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis Han, Win Min Avihingsanon, Anchalee Rajasuriar, Reena Tanuma, Junko Mundhe, Sanjay Lee, Man-Po Choi, Jun Yong Pujari, Sanjay Chan, Yu-Jiun Somia, Agus Zhang, Fujie Kumarasamy, Nagalingeswaran Ng, Oon Tek Gani, Yasmin Chaiwarith, Romanee Pham, Thach Ngoc Do, Cuong Duy Ditangco, Rossana Kiertiburanakul, Sasisopin Khol, Vohith Ross, Jeremy Jiamsakul, Awachana Asia-Pacific, IeDEA R Medicine 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. Lippincott, Williams & Wilkins 2023-02 Article PeerReviewed Han, Win Min and Avihingsanon, Anchalee and Rajasuriar, Reena and Tanuma, Junko and Mundhe, Sanjay and Lee, Man-Po and Choi, Jun Yong and Pujari, Sanjay and Chan, Yu-Jiun and Somia, Agus and Zhang, Fujie and Kumarasamy, Nagalingeswaran and Ng, Oon Tek and Gani, Yasmin and Chaiwarith, Romanee and Pham, Thach Ngoc and Do, Cuong Duy and Ditangco, Rossana and Kiertiburanakul, Sasisopin and Khol, Vohith and Ross, Jeremy and Jiamsakul, Awachana and Asia-Pacific, IeDEA (2023) CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis. Journal of Acquired Immune Deficiency Syndromes, 92 (2). pp. 180-188. ISSN 1525-4135, DOI https://doi.org/10.1097/QAI.0000000000003121 <https://doi.org/10.1097/QAI.0000000000003121>. 10.1097/QAI.0000000000003121
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	R Medicine
spellingShingle	R Medicine Han, Win Min Avihingsanon, Anchalee Rajasuriar, Reena Tanuma, Junko Mundhe, Sanjay Lee, Man-Po Choi, Jun Yong Pujari, Sanjay Chan, Yu-Jiun Somia, Agus Zhang, Fujie Kumarasamy, Nagalingeswaran Ng, Oon Tek Gani, Yasmin Chaiwarith, Romanee Pham, Thach Ngoc Do, Cuong Duy Ditangco, Rossana Kiertiburanakul, Sasisopin Khol, Vohith Ross, Jeremy Jiamsakul, Awachana Asia-Pacific, IeDEA CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
description	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.
format	Article
author	Han, Win Min Avihingsanon, Anchalee Rajasuriar, Reena Tanuma, Junko Mundhe, Sanjay Lee, Man-Po Choi, Jun Yong Pujari, Sanjay Chan, Yu-Jiun Somia, Agus Zhang, Fujie Kumarasamy, Nagalingeswaran Ng, Oon Tek Gani, Yasmin Chaiwarith, Romanee Pham, Thach Ngoc Do, Cuong Duy Ditangco, Rossana Kiertiburanakul, Sasisopin Khol, Vohith Ross, Jeremy Jiamsakul, Awachana Asia-Pacific, IeDEA
author_facet	Han, Win Min Avihingsanon, Anchalee Rajasuriar, Reena Tanuma, Junko Mundhe, Sanjay Lee, Man-Po Choi, Jun Yong Pujari, Sanjay Chan, Yu-Jiun Somia, Agus Zhang, Fujie Kumarasamy, Nagalingeswaran Ng, Oon Tek Gani, Yasmin Chaiwarith, Romanee Pham, Thach Ngoc Do, Cuong Duy Ditangco, Rossana Kiertiburanakul, Sasisopin Khol, Vohith Ross, Jeremy Jiamsakul, Awachana Asia-Pacific, IeDEA
author_sort	Han, Win Min
title	CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
title_short	CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
title_full	CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
title_fullStr	CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
title_full_unstemmed	CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis
title_sort	cd4/cd8 ratio recovery among people living with hiv starting with first-line integrase strand transfer inhibitors: a prospective regional cohort analysis
publisher	Lippincott, Williams & Wilkins
publishDate	2023
url	http://eprints.um.edu.my/38693/
_version_	1772811756026986496
score	13.211869

CD4/CD8 ratio recovery among people living with HIV starting with first-line integrase strand transfer inhibitors: A prospective regional cohort analysis

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