Influencia sobre la evolución del cociente CD4/CD8 de la utilización de distintas pautas de tratamiento antirretroviral

Abstract

BACKGROUND: CD4/CD8 ratio is a potential marker of immune activation and risk of developing non- AIDS events. A low ratio is associated with persistent chronic immune dysfunction, T cell activation and immune senescence. An optimal response to antirretroviral (AVR) therapy requires normalization of CD4/CD8 ratio, but this only occurs in a minority of patients. END POINT: To determine the evolution of CD4/CD8 ratio in HIV patients on effective AVR therapy in relation to the different ARV regimens used and whether there are differences among them or not. METHODS: A cohort of HIV patients from 1980-2014 is analyzed, receiving suppressor regimens based on non-nucleoside reverse-transcriptase inhibitors (NNRTI), Protease Inhibitors (PI) or integrase inhibitors (II) with a duration of at least 6 months and a CD4/CD8 ratio ≤ 1, at the begining of the different each regimen. RESULTS: There were 880 treatment regimens studied, incluiding 502 patients with a mean age of 41.95 years, mostly men (78.49%) of Spanish nationality (81.28%). The HIV infection risk factors were: 46.02% users of intravenous drugs, 23.51% homosexuals and 22.51% heterosexuals. Hepatitis C co-infection, was found in %. Broadly, with each treatment regimen, there is a trend towards and increase of the CD4 / CD8 ratio during the follow up, and a minority of patiens have achieved the goal of normalization (ratio ≥ 1). The different treatment regimens, seem to determine a different evolution of the cd4/cd8 ratio, observing a better trend with the II regimen, but these data are yet to be analyzed . CONCLUSIONS: Finding differences among ARV regimens, could contribute to develop better therapies targeting immune restoration in HIV patients.