title: First-line cART regimen impacts the course of CD8+ T-cell counts in HIV-infected patients that achieve sustained undetectable viral load.
abstract: The aim of the study was to investigate the impact of first-line combined antiretroviral therapy (cART) regimen on the course of CD8 T-cell counts in human immunodeficiency virus (HIV)-infected patients.A retrospective observational study conducted on the French DAT'AIDS Cohort of HIV-infected patients.We selected 605 patients initiating a first-line cART between 2002 and 2009, and which achieved a sustained undetectable HIV plasma viral load (pVL) for at least 12 months without cART modification. The evolution of CD8 T-cell counts according to cART regimen was assessed.CD8 T-cell counts were assessed in 572 patients treated with 2NRTIs+1PI/r (n= 297), 2NRTIs+1NNRTI (n= 207) and 3NRTIs (n= 68). In multivariate analysis, after 12 months of follow-up, the 3NRTIs regimen was associated with a significantly smaller decrease of CD8 T-cell count compared with NNRTI-containing regimens (-10.2 cells/μL in 3NRTIs vs -105.1 cells/μL; P=0.02) but not compared with PI-containing regimens (10.2 vs -60.9 cells/μL; P=0.21). After 24 months, the 3NRTIs regimen was associated with a smaller decrease of CD8 T-cell count and % compared with PI/r- and NNRTI-containing regimens (0.2 in 3NRTIs vs -9.9 with PI/r-regimens, P=0.001, and vs -11.1 with NNRTI-regimens, p < 0.0001). A focus analysis on 11 patients treated with an INSTI-containing cART regimen during the study period showed after 12 months of follow-up, a median decrease of CD8 T-cell count of -155 [inter quartile range: -302; -22] cells/μL.Our data highlight the fact that cART regimens have differential effects on CD8 pool down regulation.
authors.affiliation: Aix-Marseille University, APHM Hôpital Sainte-Marguerite, Immuno-Hematology Clinic Inserm U912 (SESSTIM), Marseille CHU Hotel Dieu, Infectious Diseases Unit, Nantes Inserm Université de Toulouse III, UMR1027, Toulouse APHP- Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectious Diseases Center, IHU Imagine Pasteur Institut, Medical Care Center, Necker-Pasteur Infectious Diseases Center France Université Paris Descartes, Sorbonne Paris Cité, Paris Infectious Diseases Department, CHU of Nice, University Nice Sophia-Antipolis Hôpitaux Universitaires Strasbourg, Center for HIV care, Strasbourg Hospital Tourcoing, Infectious Disease Unit, Tourcoing INSERM, UMR 1027, Toulouse III University, Toulouse, F-31000, France; CHU Toulouse, COREVIH Toulouse, F-31000 AP-HP, Hospital Pitie-Salpetriere, Department of Infectious Diseases UPMC Univ Paris UMRS 943, Paris CHU de Fort de France, Service de maladies infectieuses et tropicales, Martinique Université des Antilles, Faculté de Médecine Hyacinthe Bastaraud, EA 4537; Centre Hospitalier Universitaire de Pointe-à-Pitre, Inserm CIC1424, Service de Maladies Infectieuses et Tropicales, Dermatologie, Médecine Interne, Pointe-à-Pitre, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.forename: Clotilde
authors.initials: C
authors.lastname: Allavena
authors.forename: Cyrille
authors.initials: C
authors.lastname: Delpierre
authors.forename: Claudine
authors.initials: C
authors.lastname: Duvivier
authors.forename: Véronique
authors.initials: V
authors.lastname: Obry-Roguet
authors.forename: Carla E
authors.initials: CE
authors.lastname: Cano
authors.forename: Francine
authors.initials: F
authors.lastname: Guillouet de Salvador
authors.forename: David
authors.initials: D
authors.lastname: Rey
authors.forename: Pierre
authors.initials: P
authors.lastname: Dellamonica
authors.forename: Antoine
authors.initials: A
authors.lastname: Cheret
authors.forename: Lise
authors.initials: L
authors.lastname: Cuzin
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: André
authors.initials: A
authors.lastname: Cabié
authors.forename: Bruno
authors.initials: B
authors.lastname: Hoen
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors