title: Maintenance of virologic efficacy and decrease in levels of β2-microglobulin, soluble CD40L and soluble CD14 after switching previously treated HIV-infected patients to an NRTI-sparing dual therapy.
abstract: Novel strategies are necessary to decrease inflammatory parameters in successfully treated HIV-infected patients. Our aim was to evaluate the maintenance of viral suppression and potential changes in inflammatory, immune-activation and coagulation biomarkers in virologically suppressed HIV-infected patients switched to a nucleoside reverse transcriptase inhibitor-sparing (NRTI) and maraviroc (MVC)-containing combined antiretroviral therapy (cART). Fifty-eight HIV-infected patients were observed after their treatment regimens were changed to MVC 150mg/once daily plus ritonavir-boosted protease inhibitor therapy. Activation-, inflammation- and coagulation-associated biomarkers and mitochondrial (mt)DNA were analyzed after a median of 24weeks of follow-up. We observed that after changing to an NRTI-sparing regimen, 96.6% of HIV-patients on viral suppressive cART maintained viral suppression and their CD4+ T cell counts did not change significantly (median of 31weeks of follow-up). This cART switch reduced soluble CD40 ligand (p=0.002), beta-2 microglobulin (p=0.025), and soluble CD14 (p=0.009) in patients with higher baseline levels of these inflammation biomarkers after a median of 24weeks of follow-up. The results of our study show that changing to NRTI-sparing dual therapy decreased the levels of inflammatory biomarkers and maintained the immune-virologic efficacy. The potential benefits of this regimen warrant further investigation to uncover the association of this therapy with the potential decrease in the morbidity and mortality of HIV-infected patients from non-AIDS-defining illnesses.
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain.
authors.forename: M Concepción
authors.initials: MC
authors.lastname: Romero-Sánchez
authors.affiliation: Department of Clinical Biochemistry, Virgen del Rocío University Hospital (IBiS/CSIC/SAS/University of Seville), Seville 41013, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Alvarez-Ríos
authors.affiliation: Infectious Diseases Section, Reina Sofía University General Hospital, Murcia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Bernal-Morell
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Genebat
authors.affiliation: Infectious Diseases Section, Santa María del Rosell-Santa Lucía Hospital, Cartagena, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Vera
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain; Department of Medical Biochemistry, Molecular Biology, and Immunology, School of Medicine, University of Seville, Spain.
authors.forename: Mohammed Rafii-El-Idrissi
authors.initials: MR
authors.lastname: Benhnia
authors.affiliation: Infectious Diseases Section, Morales Meseguer University General Hospital, Murcia, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Bravo-Urbieta
authors.affiliation: Infectious Diseases Section, Virgen de la Arrixaca Hospital, Murcia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Galera-Peñaranda
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain.
authors.forename: Rebeca S
authors.initials: RS
authors.lastname: de Pablo-Bernal
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain.
authors.forename: María Antonia
authors.initials: MA
authors.lastname: Abad-Carrillo
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain. Electronic address: mleal@telefonica.net.
authors.forename: Manuel
authors.initials: M
authors.lastname: Leal
authors.affiliation: Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain. Electronic address: ezequiel.ruizmateos@gmail.com.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Ruiz-Mateos
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D023201:CD40 Ligand / Q000097:blood*; D003510:Cyclohexanes / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D000077592:Maraviroc; D008875:Middle Aged; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D014230:Triazoles / Q000008:administration & dosage*; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D003510:Cyclohexanes; D018950:Lipopolysaccharide Receptors; D018894:Reverse Transcriptase Inhibitors; D014230:Triazoles; D001613:beta 2-Microglobulin; D023201:CD40 Ligand; D000077592:Maraviroc
keywords: HIV infection; Inflammatory markers; Maraviroc; NRTIs; cART