Integrase inhibitor-based regimens are related to favorable systemic inflammatory index and platecrit scores in people living with HIV (PLWH) up to 2 years


Sahin E. A. , Mavi D., KARA E., SÖNMEZER M. Ç. , İNKAYA A. Ç. , ÜNAL S.

POSTGRADUATE MEDICINE, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1080/00325481.2022.2085931
  • Journal Name: POSTGRADUATE MEDICINE
  • Journal Indexes: Science Citation Index Expanded, Scopus, CAB Abstracts, CINAHL, EBSCO Education Source, Educational research abstracts (ERA), EMBASE, International Pharmaceutical Abstracts, MEDLINE, Veterinary Science Database
  • Keywords: Inflammation, antiretroviral therapy (ART), integrase strand transfer inhibitors (INSTI), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI), protease inhibitors (PI), MYOCARDIAL-INFARCTION, IMMUNE ACTIVATION, ANTIRETROVIRAL THERAPY, CARDIOVASCULAR-DISEASE, INFECTED PATIENTS, LYMPHOCYTE RATIO, RISK-FACTORS, PLATELET, INDIVIDUALS, ASSOCIATION

Abstract

Objectives Despite the advances in antiretroviral treatment (ART), persistent inflammation remained a challenge. We analyzed the inflammatory-score changes through 2-years in people living with HIV (PLWH) treated with different antiretroviral regimes. Methods This study was conducted in Hacettepe University HIV/AIDS Treatment and Research Center. PLWH diagnosed between 2014 and 2020 were included. Inflammatory and metabolic markers (CD4/CD8 ratio, C-reactive protein (CRP), Systemic Inflammatory Index (SII), Neutrophil-Lymphocyte Ratio (NLR), Mean Platelet Volume (MPV), Platecrite (PCT), and Low-Density Lipoprotein/High-Density Lipoprotein (LDL/HDL), Platelet-to-Lymphocyte Ratio (PLR) and ARTs were captured from database through 2-years from the diagnosis. The 2-year change (Delta) in markers was calculated and compared by ART type (backbone and 3rd agent). Mann-Whitney-U test and T-test were used for statistical analysis. Results This study included 205 PLWH; 175 (85.4%) were male, and the mean age was 38.98 (+/- 10.88) years. The number of PLWH with suppressed viremia (<40 HIV-RNA copies/ml) was 164 (80%) at the end of the second year. MPV increased significantly higher among PLWH receiving ABC/3TC compared to PLWH receiving TDF/FTC (p < 0.05). The CD4:CD8 ratio increased, and SII, NLR, LDL/HDL ratios decreased significantly among PLWH treated with integrase strand transfer inhibitors (INSTI) compared with protease inhibitors (PI) and Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) (p < 0.05). Conclusions Integrase inhibitor treatment is related to favorable inflammatory marker profile among PLWH in the 2-year follow-up. A favorable inflammatory profile may, in turn, contribute to the prevention of non-communicable diseases (NCD) among PLWH. This study showed that simple, easy-to-calculate markers could be implemented to define ongoing inflammation among PLWH under suppressive ART.