Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Nitsotolis Thomas
Dissertation committee:
Μήνα Ψυχογυιού, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Δαΐκος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μιχαήλ Σαμάρκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αναστάσιος Κόλλιας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αντώνιος Παπαδόπουλος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Παρασκευής, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γαρυφαλλιά Πουλάκου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Σύγκριση της επίδρασης των αναστολέων της ιντεγκράσης και των αναστολέων της πρωτεάσης στη μείωση της ανοσολογικής διέγερσης και στη βακτηριακή αλλόθεση, σε HIV (+) άτομα υπό αγωγή και που έχουν επιτύχει αριθμό CD4+>350/μL και μη ανιχνεύσιμο ιικό φορτίο για τουλάχιστον πάνω από 6 μήνες
Translated title:
Comparison of integrase strand transfer inhibitors (INSTIs) and protease-boosted inhibitors (PIs) on the reduction in chronic immune activation in a virally suppressed, mainly male population living with HIV (PLWH)
Summary:
Background and Objectives: The success of combined antiretroviral therapy (cART) has led to a dramatic improvement in the life expectancy of people living with HIV (PLWH). However, there has been an observed increase in cardiometabolic, bone, renal, hepatic, and neurocognitive manifestations, as well as neoplasms, known as serious non-AIDS events/SNAEs, compared to the general population of corresponding age. This increase is linked to a harmful phenomenon called inflammaging/immunosenescence, which is driven by chronic immune activation and intestinal bacterial translocation. In this study, we examined immunological and metabolic parameters in individuals receiving current cART.
Materials and Methods: The study was conducted at Laiko General Hospital in Athens, Greece. Plasma concentrations of sCD14, IL-6, SuPAR, I-FABP, and LBP were measured in virally suppressed PLWH under cART with at least 350 CD4+ lymphocytes/µL. We compared these levels between PLWH receiving integrase strand transfer inhibitors (INSTIs) and protease inhibitors (PIs) and attempted to correlate them with chronic immune activation and metabolic parameters.
Results: Data from 28 PLWH were analyzed, with a mean age of 52 and 93% being males. Among the two comparison groups, IL-6 levels were higher in the PIs group (5.65 vs. 7.11 pg/mL, p = 0.03). No statistically significant differences were found in the other measured parameters. A greater proportion of PLWH under INSTIs had normal-range LBP (33% vs. 0%, p = 0.04). When using inverse probability of treatment weighting, no statistically significant differences in the measured parameters were found between the two groups (sCD14 p = 0.511, IL-6 p = 0.383, SuPAR p = 0.793, I-FABP p = 0.868, and LBP p = 0.663). Glucose levels were found to increase after viral suppression in the entire sample (92 mg/dL vs. 98 mg/dL, p = 0.009). Total (191 mg/dL vs. 222 mg/dL, p = 0.005) and LDL cholesterol (104 mg/dL vs. 140 mg/dL, p = 0.002) levels were higher in the PIs group. No significant differences were observed in liver and renal function tests.
Conclusions: Further investigation is warranted for PLWH on cART-containing INSTIs regimens to explore potential reductions in chronic immune activation and intestinal bacterial translocation.
Main subject category:
Health Sciences
Keywords:
Chronic immune activation, Intestinal bacterial translocation, Integrase strand transfer inhibitors (INSTIs), Protease-boosted inhibitors (PIs), Interleukin-6
