Impact of very early antiretroviral therapy during acute HIV infection on long-term immunovirological outcomes.
Int J Infect Dis
; 136: 100-106, 2023 Nov.
Article
em En
| MEDLINE
| ID: mdl-37726066
ABSTRACT
OBJECTIVES:
We aimed to determine if starting antiretroviral therapy (ART) in the first 30 days after acquiring HIV infection has an impact on immunovirological response.METHODS:
Observational, ambispective study including 147 patients with confirmed acute HIV infection (January/1995-August/2022). ART was defined as very early (≤30 days after the estimated date of infection), early (31-180 days), and late (>180 days). We compared time to viral suppression (viral load [VL] <50 copies/ml) and immune recovery (IR) (CD4+/CD8+ ratio ≥1) according to the timing and type of ART using survival analysis.RESULTS:
ART was started in 140 (95.2%) patients. ART was very early in 24 (17.1%), early in 77 (55.0%), and late in 39 (27.9%) cases. Integrase strand transfer inhibitor (INSTI)-based regimens were the most used in both the overall population (65%) and the very early ART group (23/24, 95.8%). Median HIV VL and CD4+/CD8+ ratio pre-ART were higher in the very early ART group (P <0.05). Patients in the very early and early ART groups and treated with INSTI-based regimens achieved IR earlier (P <0.05). Factors associated with faster IR were the CD4+/CD8+ ratio pre-ART (hazard ratio 9.3, 95% CI 3.1-27.8, P <0.001) and INSTI-based regimens (hazard ratio 2.4, 95% CI 1.3-4.2, P = 0.003).CONCLUSIONS:
The strongest predictors of IR in patients who start ART during AHI are the CD4+/CD8+ ratio pre-ART and INSTI-based ART regimens.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Fármacos Anti-HIV
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article