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CD4/CD8 Ratio Outcome According to the Class of the Third Active Drug in Antiretroviral Therapy Regimens: Results From the Quebec Human Immunodeficiency Virus Cohort Study.
- Source :
- Clinical Infectious Diseases; Jun2023, Vol. 76 Issue 11, p1879-1888, 10p
- Publication Year :
- 2023
-
Abstract
- Background The impact of different therapeutic classes of drugs in antiretroviral therapy (ART) regimens on the CD4/CD8 ratio is not well documented in people treated for HIV. The objective of this study was to analyze the long-term effect of exposure to integrase strand transfer inhibitor (INSTI) on CD4/CD8 ratio compared with nonnucleoside reverse transcriptase inhibitor (NNRTI) or protease inhibitor (PI) among ART-treated persons with HIV (PWH). Methods Data from the Quebec HIV Cohort collected from 31 August 2017 were used. Our analysis included all patients in the cohort who received a first or subsequent ART regimen composed of 2 nucleoside reverse transcriptase inhibitors (NRTIs) and a third active drug of a different class (NNRTI, PI, or INSTI) for at least 16 weeks. Marginal structural Cox models were constructed to estimate the effect of different therapeutic classes on the CD4/CD8 ratio outcome. Results Among the 3907 eligible patients, 972 (24.9%), 1996 (51.1%), and 939 (24.0%) were exposed to an ART regimen whose third active agent was an NNRTI, PI, or INSTI, respectively. The total follow-up time was 13 640.24 person-years. The weighted hazard ratio for the association between the third active class and CD4/CD8 ratio ≥1 was.56 (95% confidence interval [CI]:.48–.65) for patients exposed to NNRTI + 2 NRTIs and.41 (95% CI:.35–.47) for those exposed to PI + 2 NRTIs, compared with those exposed INSTI + 2 NRTIs. Conclusions For people treated for HIV, INSTI-based ART appears to be associated with a higher CD4/CD8 ratio than NNRTI and PI-based ART. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV infections
HIV integrase inhibitors
PROTEASE inhibitors
CONFIDENCE intervals
VIRAL load
REVERSE transcriptase inhibitors
ANTIRETROVIRAL agents
PROTEOLYTIC enzymes
HIGHLY active antiretroviral therapy
TREATMENT effectiveness
COMPARATIVE studies
CD4 lymphocyte count
IMMUNITY
DESCRIPTIVE statistics
RESEARCH funding
T cells
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 76
- Issue :
- 11
- Database :
- Complementary Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 164219245
- Full Text :
- https://doi.org/10.1093/cid/ciad056