CD4/CD8 Ratio Recovery among People Living with HIV Starting with First-Line Integrase Strand Transfer Inhibitors: A Prospective Regional Cohort Analysis

Issued Date

2023-02-01

Resource Type

Article

ISSN

15254135

eISSN

10779450

DOI

10.1097/QAI.0000000000003121

Scopus ID

2-s2.0-85146139741

Pubmed ID

36625858

Journal Title

Journal of Acquired Immune Deficiency Syndromes

Volume

92

Issue

2

Start Page

180

End Page

188

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of Acquired Immune Deficiency Syndromes Vol.92 No.2 (2023) , 180-188

Suggested Citation

Han W.M., Avihingsanon A., Rajasuriar R., Tanuma J., Mundhe S., Lee M.P., Choi J.Y., Pujari S., Chan Y.J., Somia A., Zhang F., Kumarasamy N., Tek Ng O., Gani Y., Chaiwarith R., Pham T.N., Do C.D., Ditangco R., Kiertiburanakul S., Khol V., Ross J., Jiamsakul A., Ly P.S., Zhao H.X., Han N., Li P.C.K., Lam W., Chan Y.T., Ezhilarasi C., Joshi K., Gaikwad S., Chitalikar A., Sangle S., Mave V., Marbaniang I., Nimkar S., Merati T.P., Wirawan D.N., Yuliana F., Yunihastuti E., Widhani A., Maria S., Karjadi T.H., Oka S., Nishijima T., Na S., Kim J.M., Rudi N.B., Azwa I., Kamarulzaman A., Syed Omar S.F., Ponnampalavanar S., Pasayan M.K., Mationg M.L., Ku W.W., Wu P.C., Ke E., Lim P.L., Lee L.S., Liang D., Gatechompol S., Phanuphak P., Phadungphon C., Phuphuakrat A., Chumla L., Sanmeema N., Sirisanthana T., Praparattanapan J., Nuket K., Khusuwan S., Kantipong P., Kambua P., Nguyen K.V., Bui H.V., Nguyen D.T.H., Nguyen D.T.H., Ngo A.V., Nguyen L.T., Sohn A.H., Ross J., Petersen B., Law M.G., Bijker R., Rupasinghe D. CD4/CD8 Ratio Recovery among People Living with HIV Starting with First-Line Integrase Strand Transfer Inhibitors: A Prospective Regional Cohort Analysis. Journal of Acquired Immune Deficiency Syndromes Vol.92 No.2 (2023) , 180-188. 188. doi:10.1097/QAI.0000000000003121 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82433

Title

CD4/CD8 Ratio Recovery among People Living with HIV Starting with First-Line Integrase Strand Transfer Inhibitors: A Prospective Regional Cohort Analysis

Author(s)

Han W.M.
 Avihingsanon A.
 Rajasuriar R.
 Tanuma J.
 Mundhe S.
 Lee M.P.
 Choi J.Y.
 Pujari S.
 Chan Y.J.
 Somia A.
 Zhang F.
 Kumarasamy N.
 Tek Ng O.
 Gani Y.
 Chaiwarith R.
 Pham T.N.
 Do C.D.
 Ditangco R.
 Kiertiburanakul S.
 Khol V.
 Ross J.
 Jiamsakul A.
 Ly P.S.
 Zhao H.X.
 Han N.
 Li P.C.K.
 Lam W.
 Chan Y.T.
 Ezhilarasi C.
 Joshi K.
 Gaikwad S.
 Chitalikar A.
 Sangle S.
 Mave V.
 Marbaniang I.
 Nimkar S.
 Merati T.P.
 Wirawan D.N.
 Yuliana F.
 Yunihastuti E.
 Widhani A.
 Maria S.
 Karjadi T.H.
 Oka S.
 Nishijima T.
 Na S.
 Kim J.M.
 Rudi N.B.
 Azwa I.
 Kamarulzaman A.
 Syed Omar S.F.
 Ponnampalavanar S.
 Pasayan M.K.
 Mationg M.L.
 Ku W.W.
 Wu P.C.
 Ke E.
 Lim P.L.
 Lee L.S.
 Liang D.
 Gatechompol S.
 Phanuphak P.
 Phadungphon C.
 Phuphuakrat A.
 Chumla L.
 Sanmeema N.
 Sirisanthana T.
 Praparattanapan J.
 Nuket K.
 Khusuwan S.
 Kantipong P.
 Kambua P.
 Nguyen K.V.
 Bui H.V.
 Nguyen D.T.H.
 Nguyen D.T.H.
 Ngo A.V.
 Nguyen L.T.
 Sohn A.H.
 Ross J.
 Petersen B.
 Law M.G.
 Bijker R.
 Rupasinghe D.

Author's Affiliation

The Voluntary Health Services, Chennai
 Hospital Sungai Buloh
 Beijing Ditan Hospital Capital Medical University
 VHS Medical Centre India
 Gokila
 Bach Mai Hospital
 Universitas Udayana
 Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
 Thai Red Cross Agency
 Universiti Malaya
 The Kirby Institute
 National Center for Global Health and Medicine
 Yonsei University College of Medicine
 Faculty of Medicine Ramathibodi Hospital, Mahidol University
 Queen Elizabeth Hospital Hong Kong
 University of Malaya Medical Centre
 Veterans General Hospital-Taipei
 Faculty of Medicine, Chulalongkorn University
 Tan Tock Seng Hospital
 Chiang Mai University
 Sassoon General Hospital
 National Hospital for Tropical Diseases
 National Center for HIV/AIDS
 amfAR - The Foundation for AIDS Research
 Research Institute for Health Sciences
 Institute of Infectious Diseases
 Chiangrai Prachanukroh Hospital

Other Contributor(s)

Mahidol University

Abstract

Background:We evaluated trends in CD4/CD8 ratio among people living with HIV (PLWH) starting antiretroviral therapy (ART) with first-line integrase strand transfer inhibitors (INSTI) compared with non-INSTI-based ART, and the incidence of CD4/CD8 ratio normalization.Methods:All PLWH enrolled in adult HIV cohorts of IeDEA Asia-Pacific who started with triple-ART with at least 1 CD4, CD8 (3-month window), and HIV-1 RNA measurement post-ART were included. CD4/CD8 ratio normalization was defined as a ratio ≥1. Longitudinal changes in CD4/CD8 ratio were analyzed by linear mixed model, the incidence of the normalization by Cox regression, and the differences in ratio recovery by group-based trajectory modeling.Results:A total of 5529 PLWH were included; 80% male, median age 35 years (interquartile range [IQR], 29-43). First-line regimens were comprised of 65% NNRTI, 19% PI, and 16% INSTI. The baseline CD4/CD8 ratio was 0.19 (IQR, 0.09-0.33). PLWH starting with NNRTI-(P = 0.005) or PI-based ART (P = 0.030) had lower CD4/CD8 recovery over 5 years compared with INSTI. During 24,304 person-years of follow-up, 32% had CD4/CD8 ratio normalization. After adjusting for age, sex, baseline CD4, HIV-1 RNA, HCV, and year of ART initiation, PLWH started with INSTI had higher odds of achieving CD4/CD8 ratio normalization than NNRTI-(P < 0.001) or PI-based ART (P = 0.015). In group-based trajectory modeling analysis, INSTI was associated with greater odds of being in the higher ratio trajectory.Conclusions:INSTI use was associated with higher rates of CD4/CD8 ratio recovery and normalization in our cohort. These results emphasize the relative benefits of INSTI-based ART for immune restoration.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/82433

Collections

Scopus 2023