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First-line cART regimen impacts the course of CD8+ T-cell counts in HIV-infected patients that achieve sustained undetectable viral load.
Auteur(s) : Poizot-Martin, Isabelle Allavena, Clotilde Delpierre, Cyrille Duvivier, Claudine Obry-Roguet, Véronique Cano, Carla E Guillouet De Salvador, Francine Rey, David
Auteurs secondaires : Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM) ; Institut de Recherche pour le Développement (IRD) - Aix Marseille Université (AMU) - ORS PACA - Institut National de la Santé et de la Recherche Médicale (INSERM) Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ) Service des maladies infectieuses et tropicales [CHU Nantes] ; CHU Nantes Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse] ; Université Paul Sabatier - Toulouse 3 (UPS) - Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d’Infectiologie Necker Pasteur ; CHU Necker - Enfants Malades [AP-HP] - Université Paris Descartes - Paris 5 (UPD5) - Assistance publique - Hôpitaux de Paris (AP-HP) Service des maladies infectieuses ; CHU Nice - University Hospital Les Hôpitaux Universitaires de Strasbourg (HUS) Université Paris Descartes - Paris 5 (UPD5)

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
The aim of the study was to investigate the impact of first-line combined antiretroviral therapy (cART) regimen on the course of CD8 + T-cell counts in human immunodeficiency virus (HIV)-infected patients. A retrospective observational study conducted on the French DAT'AIDS Cohort of HIV-infected patients. We selected 605 patients initiating a first-line cART between 2002 and 2009, and which achieved a sustained undetectable HIV plasma viral load (pVL) for at least 12 months without cART modification. The evolution of CD8 + T-cell counts according to cART regimen was assessed. CD8 + T-cell counts were assessed in 572 patients treated with 2NRTIs+1PI/r (n= 297), 2NRTIs+1NNRTI (n= 207) and 3NRTIs (n= 68). In multivariate analysis, after 12 months of follow-up, the 3NRTIs regimen was associated with a significantly smaller decrease of CD8 + T-cell count compared with NNRTI-containing regimens (–10.2 cells/mL in 3NRTIs vs –105.1 cells/mL; P=0.02) but not compared with PI-containing regimens (10.2 vs –60.9 cells/mL; P=0.21). After 24 months, the 3NRTIs regimen was associated with a smaller decrease of CD8 + T-cell count and % compared with PI/r-and NNRTI-containing regimens (0.2 in 3NRTIs vs –9.9 with PI/r-regimens, P=0.001, and vs –11.1 with NNRTI-regimens, p < 0.0001). A focus analysis on 11 patients treated with an INSTI-containing cART regimen during the study period showed after 12 months of follow-up, a median decrease of CD8 + T-cell count of –155 [inter quartile range: –302; –22] cells/mL. Our data highlight the fact that cART regimens have differential effects on CD8 pool down regulation. Abbreviations: cART = combined antiretroviral therapy, HIV = human immunodeficiency virus, INSTI = integrase strand transfer inhibitor, NNRTI = non-nucleotide reverse transcriptase inhibitor, NRTI = nucleotide reverse transcriptase inhibitor, PI/r = Ritonavir-boosted protease inhibitor, pVL = plasma viral load.
ISSN: 0025-7974

inserm-01408002
http://www.hal.inserm.fr/inserm-01408002
http://www.hal.inserm.fr/inserm-01408002/document
http://www.hal.inserm.fr/inserm-01408002/file/2016%2C%20Poizot-Martin%20-%20First-line%20cART%20regimen%20impacts%20the%20course%20of%20CD8%2B%20T-cell%20counts%20in%20HIV-infected%20patients.pdf
DOI : 10.1097/MD.0000000000005087

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