Immunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection.
Immunological, Cognitive, and Psychiatric Outcomes After Initiating Efavirenz- and Dolutegravir-based Antiretroviral Therapy During Acute Human Immunodeficiency Virus Infection.
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DOI：
10.1093/cid/ciac466
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发表时间：
2023-02-08
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影响因子：
--
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基于依法韦仑（EFV）和度鲁特韦（DTG）的抗逆转录病毒治疗（ART）是以前和现在推荐的用于人类免疫缺陷病毒1型（HIV-1）初治个体的方案。它们是否影响免疫学和神经精神病学特征差异尚不清楚。这项回顾性分析包括258名急性HIV-1感染（AHI）期间入组的参与者。参与者在AHI期间启动了3种ART方案中的1种：基于EFV（n = 131），基于DTG（n = 92）或DTG+马拉韦罗（DTG/MVC，n = 35）。所有方案均包括2种核苷类逆转录酶抑制剂，并维持96周。比较了CD 4+和CD 8 + T细胞计数、情绪症状和4项神经心理学测试组合（NPZ-4）的综合评分。基线时，中位年龄为26岁，99%为男性，36%在Fiebig I-II期入组。两组在第24周和第96周的血浆病毒抑制相似。与EFV组相比，DTG组在第96周显示出更大的CD 4+（P <0.001）和CD 8+（P = 0.015）T细胞计数的增加，但CD 4/CD 8比值的增加相似。在第24周，两组之间的NPZ-4改善相似，但在第96周，DTG组的改善更大（P = .005）。随访时，两组患者基于患者健康问卷和痛苦温度计的抑郁情绪和痛苦症状相似。DTG/MVC组的结果与DTG组和EFV组的结果相当。在患有AHI的个体中，96周基于DTG的ART与CD 4+和CD 8 + T细胞计数的更大增量以及认知能力的改善相关。与以依法韦仑为基础的方案相比，在急性人类免疫缺陷病毒期间启动以度鲁特韦为基础的方案与治疗后96周的CD 4+和CD 8 + T细胞计数和神经认知评估的更大改善相关，但与CD 4/CD 8比值和抑郁和焦虑/痛苦症状评分相似。
Efavirenz (EFV)- and dolutegravir (DTG)-based antiretroviral therapy (ART) is the former and current recommended regimen for treatment-naive individuals with human immunodeficiency virus type 1 (HIV-1). Whether they impact the immunological and neuropsychiatric profile differentially remains unclear. This retrospective analysis included 258 participants enrolled during acute HIV-1 infection (AHI). Participants initiated 1 of 3 ART regimens during AHI: EFV-based (n = 131), DTG-based (n = 92), or DTG intensified with maraviroc (DTG/MVC, n = 35). All regimens included 2 nucleoside reverse-transcriptase inhibitors and were maintained for 96 weeks. CD4+ and CD8+ T-cell counts, mood symptoms, and composite score on a 4-test neuropsychological battery (NPZ-4) were compared. At baseline, the median age was 26 years, 99% were male, and 36% were enrolled during Fiebig stage I–II. Plasma viral suppression at weeks 24 and 96 was similar between the groups. Compared with the EFV group, the DTG group showed greater increments of CD4+ (P < .001) and CD8+ (P = .015) T-cell counts but a similar increment of CD4/CD8 ratio at week 96. NPZ-4 improvement was similar between the 2 groups at week 24 but greater in the DTG group at week 96 (P = .005). Depressive mood and distress symptoms based on the Patient Health Questionnaire and distress thermometer were similar between the 2 groups at follow-up. Findings for the DTG/MVC group were comparable to those for the DTG group vs the EFV group. Among individuals with AHI, 96 weeks of DTG-based ART was associated with greater increments of CD4+ and CD8+ T-cell counts and improvement in cognitive performance. Compared with efavirenz-based regimens, initiating dolutegravir-based regimens during acute human immunodeficiency virus was associated with greater improvements in CD4+ and CD8+ T-cell counts and neurocognitive assessment but a similar CD4/CD8 ratio and ratings of depression and anxiety/distress symptoms at week 96 post-treatment.
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DOI：
10.1080/13803395.2012.733682
发表时间：
2013-01-01
影响因子：
2.2
作者：
Heaps, Jodi;Valcour, Victor;Ananworanich, Jintanat
通讯作者：
Ananworanich, Jintanat
DOI：
10.1097/qai.0000000000001269
发表时间：
2017-04-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Fettiplace A;Stainsby C;Winston A;Givens N;Puccini S;Vannappagari V;Hsu R;Fusco J;Quercia R;Aboud M;Curtis L
通讯作者：
Curtis L
影响因子：
16.1
作者：
Mussini, Cristina;Lorenzini, Patrizia;Monforte, Antonella d'Arminio
通讯作者：
Monforte, Antonella d'Arminio
影响因子：
15.1
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Kanters S;Vitoria M;Zoratti M;Doherty M;Penazzato M;Rangaraj A;Ford N;Thorlund K;Anis PAH;Karim ME;Mofenson L;Zash R;Calmy A;Kredo T;Bansback N
通讯作者：
Bansback N
影响因子：
3.7
作者：
Patel DA;Snedecor SJ;Tang WY;Sudharshan L;Lim JW;Cuffe R;Pulgar S;Gilchrist KA;Camejo RR;Stephens J;Nichols G
通讯作者：
Nichols G