Immunological function restoration with lopinavir/ritonavir versus efavirenz containing regimens in HIV-infected patients : a randomized clinical trial
CD4(+) count increase has been reported to be different with lopinavir/r (LPV/r) and efavirenz (EFV)-containing regimens. The different effect of these two regimens on other immune function parameters and the relationship with the gain of CD4(+) count have not been assessed in a randomized clinical trial. Fifty antiretroviral treatment (cART) naïve HIV-infected individuals were randomized to receive LPV/r or EFV both with tenofovir/emtricitabine for 48 weeks. A substudy of immunological function restoration was performed in 22 patients (LPV/r n=10 and EFV n=12). Activation, thymic function, apoptosis, senescence, exhaustion, Treg cells, interleukin (IL)-7-receptor/IL-7 system, thymic volume, and lymphoid tissue fibrosis were evaluated at baseline and at week 48. Both groups experienced a CD4(+) count increase that was higher in the EFV group (ΔCD4(+) 88 vs. 315 cells/μl LPV/r vs. EFV, respectively, p<0.001). Despite this difference in CD4(+) gain, the change in other immune function parameters was similar in both treatment groups. Most of parameters evaluated tended to normalize after 48 weeks of cART. A significant decrease in levels of activation, senescence, exhaustion, and apoptosis on CD4(+) and CD8(+) T cells (p<0.001 for all) and a significant increase in markers of thymic function, IL-7 receptor, and in the levels of central memory CD4(+) T cells and naive subsets of CD8(+) T cells (p<0.001 for all) with respect to baseline values were observed without any difference between groups. These data indicate that the differences in CD4(+) gain with different cART regimens are not immunologically meaningful and might explain the similar clinical efficacy of these regimens.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
AIDS research and human retroviruses - 30(2014), 5 vom: 03. Mai, Seite 425-33 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Torres, Berta [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 17.08.2015 Date Revised 21.10.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1089/AID.2013.0185 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM234063653 |
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| 245 | 1 | 0 | |a Immunological function restoration with lopinavir/ritonavir versus efavirenz containing regimens in HIV-infected patients |b a randomized clinical trial |
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| 500 | |a Date Revised 21.10.2021 | ||
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| 520 | |a CD4(+) count increase has been reported to be different with lopinavir/r (LPV/r) and efavirenz (EFV)-containing regimens. The different effect of these two regimens on other immune function parameters and the relationship with the gain of CD4(+) count have not been assessed in a randomized clinical trial. Fifty antiretroviral treatment (cART) naïve HIV-infected individuals were randomized to receive LPV/r or EFV both with tenofovir/emtricitabine for 48 weeks. A substudy of immunological function restoration was performed in 22 patients (LPV/r n=10 and EFV n=12). Activation, thymic function, apoptosis, senescence, exhaustion, Treg cells, interleukin (IL)-7-receptor/IL-7 system, thymic volume, and lymphoid tissue fibrosis were evaluated at baseline and at week 48. Both groups experienced a CD4(+) count increase that was higher in the EFV group (ΔCD4(+) 88 vs. 315 cells/μl LPV/r vs. EFV, respectively, p<0.001). Despite this difference in CD4(+) gain, the change in other immune function parameters was similar in both treatment groups. Most of parameters evaluated tended to normalize after 48 weeks of cART. A significant decrease in levels of activation, senescence, exhaustion, and apoptosis on CD4(+) and CD8(+) T cells (p<0.001 for all) and a significant increase in markers of thymic function, IL-7 receptor, and in the levels of central memory CD4(+) T cells and naive subsets of CD8(+) T cells (p<0.001 for all) with respect to baseline values were observed without any difference between groups. These data indicate that the differences in CD4(+) gain with different cART regimens are not immunologically meaningful and might explain the similar clinical efficacy of these regimens | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Alkynes |2 NLM | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 650 | 7 | |a Benzoxazines |2 NLM | |
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| 700 | 1 | |a Loncá, Montserrat |e verfasserin |4 aut | |
| 700 | 1 | |a Díaz, Alba |e verfasserin |4 aut | |
| 700 | 1 | |a Alós, Llucia |e verfasserin |4 aut | |
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| 700 | 1 | |a Arnaiz, Joan Albert |e verfasserin |4 aut | |
| 700 | 1 | |a Leal, Lorna |e verfasserin |4 aut | |
| 700 | 1 | |a Lucero, Constanza |e verfasserin |4 aut | |
| 700 | 1 | |a León, Agathe |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez, Marcelo |e verfasserin |4 aut | |
| 700 | 1 | |a Negredo, Eugenia |e verfasserin |4 aut | |
| 700 | 1 | |a Clotet, Bonaventura |e verfasserin |4 aut | |
| 700 | 1 | |a Gatell, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Benito, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia, Felipe |e verfasserin |4 aut | |
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