A comparison between different anti-retroviral therapy regimes on soluble inflammation markers: a pilot study
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AIDS Research and Therapy Open Access
RESEARCH
A comparison between different anti‑retroviral therapy regimes on soluble inflammation markers: a pilot study Martina Maritati1* , Trentini Alessandro2, Nunzia Zanotta3, Manola Comar4, Tiziana Bellini2, Laura Sighinolfi5 and Carlo Contini1
Abstract Background: Although HIV-related deaths have decreased dramatically following the introduction of antiretroviral therapy (ART), HIV infection itself causes increased morbidity and mortality for both non-AIDS-related events or chronic inflammation and immune activation. The use of certain antiretroviral drugs can contribute to this process. Methods: We investigated 26 potential biomarkers in serum samples from HIV-1 infected patients virologically suppressed under ART. The main objective of our study was to evaluate if virological suppression achieved with a triple drug regimen containing tenofovir disoproxil fumarate co-formulated with emtricitabine (TDF/FTC) as backbone, could correlate with a better immunological and inflammatory profile in relation to the third class of antiretroviral drug administered. The eligible patients were then divided into 3 groups in relation to the third drug associated with TDF/FTC: nucleoside reverse transcriptase inhibitors (NNRTI) (Group 1, n = 16), protease inhibitors (PI) (Group 2, n = 17) and integrase inhibitors (INI) (Group 3, n = 16). Results: Inflammatory cytokines and chemokines were more represented in Group 2 than in Group 3 (IL-1Ra, p = 0.013; IL-12p70 p = 0.039; TNF-α p = 0.041; IL-8, p = 0.027; MIP1 β, p = 0.033). Eotaxin showed lower levels in Group 1 compared to Group 2 (p = 0.010), while IP-10 was significantly lower in Group 1 compared to both Group 2 and Group 3 (p = 0.003 and p = 0.007, respectively). Conclusions: Our results seem to discourage the administration of PI as a third drug in a virologically effective antiretroviral regimen, as its use is linked to the detection of higher levels of pro-inflammatory mediators in comparison with INI and NNRTI. Keywords: HIV, Virological suppression, Antiretroviral therapy, Immune activation, Chronic inflammation Background The introduction of antiretroviral therapy (ART) has contributed to the reduction of AIDS-related mortality among HIV-positive patients [1] and to the induced chronicity of HIV infection. Triple drug regimens that include two nucleos(t)ide reverse transcriptase inhibitors (NRTI) *Correspondence: [email protected] 1 Section of Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44124 Ferrara, Italy Full list of author information is available at the end of the article
as the backbone plus a base agent of another class, protease inhibitors (PI), integrase inhibitors (INI) or nucleoside reverse transcriptase inhibitors (NNRTI) [2], have been shown to control viral replication [3] and represent the gold standard for the treatment of HIV infection in both antiretroviral-naïve and antiretroviral experienced patients. Now, these patients live longer, although with a higher prevalence of
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