HIV/AIDS Research Reveals Equivalent Outcomes with Antiretroviral Therapy Switch

Strategic Insights -

A study published in Clinical Infectious Diseases has provided new insights into the effects of antiretroviral therapy (ART) on mid-term systemic inflammation and metabolic health in individuals with HIV-1. According to the research, switching from a widely used ART regimen, dolutegravir/lamivudine (DTG/3TC), to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) does not significantly impact systemic inflammation or metabolic parameters over 96 weeks.

Key Takeaways:

  • The study, known as INSTINCT, involved 141 adults with HIV-1 on stable DTG/3TC and sustained viral suppression, who were randomized to continue DTG/3TC or switch to BIC/FTC/TAF.
  • No significant between-group differences were observed in inflammatory biomarkers, CD4 T-cell counts, CD4/CD8 ratio, weight, lipid profile, and renal function over 96 weeks.
  • Weight changes were modest and similar; the proportion with 5% weight gain did not differ between the two groups.
  • No relevant differences were found in lipids, glucose, or estimated glomerular filtration rate (eGFR).
  • Virological suppression was maintained in 95% of participants, with adverse events being mild and balanced between groups.

Statistics:

  • The study involved 141 participants, who were randomized to continue DTG/3TC (n = 71) or switch to BIC/FTC/TAF (n = 70).
  • Over 96 weeks, no significant between-group differences were observed in inflammatory biomarkers (p > 0.05).
  • CD4 T-cell counts and CD4/CD8 ratio remained stable and comparable across arms (mean difference: 1.06 ± 0.38, p = 0.57).
  • Weight changes were modest, with a mean increase of 0.42 ± 0.85 kg (p = 0.44).
  • The proportion with 5% weight gain did not differ between the two groups (p = 0.85).

Sources:

  • Clinical Infectious Diseases
  • Oxford Univ Press Inc
  • Hospital Ramon y Cajal
  • IRYCIS and Universidad de Alcala
  • Laurmartinpedraza@gmail.com