Maintenance of virologic efficacy and decrease in levels of beta 2-microglobulin, soluble CD40L and soluble CD14 after switching previously treated HIV-infected patients to an NRTI-sparing dual therapy

• Published in: Antiviral research 2014-11, Vol.111, p.26-32
• Main Authors: Romero-Sanchez, MConcepcion, Alvarez-Rios, Ana I, Bernal-Morell, Enrique, Genebat, Miguel, Vera, Francisco, Benhnia, Mohammed Rafii-El-Idrissi, Bravo-Urbieta, Joaquin, Galera-Penaranda, Carlos, de Pablo-Bernal, Rebeca S, Abad-Carrillo, Maria Antonia, Leal, Manuel, Ruiz-Mateos, Ezequiel
• Format: Article
• Language: English
• Subjects: Human immunodeficiency virus
• ISSN: 0166-3542
• DOI: 10.1016/j.antiviral.2014.08.011

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.