Antiretroviral Regimens and CD4/CD8 Ratio Normalization in HIV-Infected Patients during the Initial Year of Treatment: A Cohort Study.
BACKGROUND
As CD4/CD8 ratio inversion has been associated with non-AIDS morbidity and mortality, predictors of ratio normalization after cART need to be studied. Here, we aimed to investigate the association of antiretroviral regimens with CD4/CD8 ratio normalization within an observational cohort.


METHODS
We selected, from a French cohort at the Nice University Hospital, HIV-1 positive treatment-naive patients who initiated cART between 2000 and 2011 with a CD4/CD8 ratio <1. Association between cART and ratio normalization (>1) in the first year was assessed using multivariate logistic regression models. Specific association with INSTI-containing regimens was examined.


RESULTS
567 patients were included in the analyses; the median CD4/CD8 ratio was 0.36. Respectively, 52.9%, 29.6% and 10.4% initiated a PI-based, NNRTI-based or NRTI-based cART regimens. About 8% of the population started an INSTI-containing regimen. 62 (10.9%) patients achieved a CD4/CD8 ratio ≥1 (N group). cART regimen was not associated with normalization when coded as PI-, NNRTI- or NRTI-based regimen. However, when considering INSTI-containing regimens alone, there was a strong association with normalization [OR, 7.67 (2.54-23.2)].


CONCLUSIONS
Our findings suggest an association between initiation of an INSTI-containing regimen and CD4/CD8 ratio normalization at one year in naïve patients. Should it be confirmed in a larger population, it would be another argument for their use as first-line regimen as it is recommended in the recent update of the "Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents".
Department of Infectiology, Nice University Hospital, Nice, F-06003, France.
F
F
De Salvador-Guillouët
Department of Clinical research and Innovation, Nice University Hospital, Nice, F-06003, France.
C
C
Sakarovitch
Department of Infectiology, Nice University Hospital, Nice, F-06003, France.
J
J
Durant
Department of Infectiology, Nice University Hospital, Nice, F-06003, France.
K
K
Risso
Department of Infectiology, Nice University Hospital, Nice, F-06003, France.
E
E
Demonchy
Department of Infectiology, Nice University Hospital, Nice, F-06003, France.
P M
PM
Roger
Department of Clinical research and Innovation, Nice University Hospital, Nice, F-06003, France.
E
E
Fontas
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D016516:CD4-CD8 Ratio; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*
D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents