Ana González-Cordón1, Lambert Assoumou2, Graeme Moyle3, Laura Waters4, Margaret Johnson5, Pere Domingo6, Julie Fox7, Hans-Jürgen Stellbrink8, Giovanni Guaraldi9, Mar Masiá10, Mark Gompels11, Stephane De Wit12, Eric Florence13, Stefan Esser14, François Raffi15, Georg Behrens16, Anton Pozniak3, José M Gatell1,17, Esteban Martínez1. 1. Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain. 2. Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France. 3. Chelsea and Westminster Hospital NHS Foundation Trust, London, UK. 4. Mortimer Market Centre, Central & North West London NHS Foundation Trust, London, UK. 5. Royal Free London NHS Foundation Trust, London, UK. 6. Hospital de Sant Pau, Barcelona, Spain. 7. Guy's & St Thomas' NHS Foundation Trust, London, UK. 8. Infektionsmedizinisches Centrum, Hamburg, Germany. 9. University of Modena and Reggio Emilia, Modena, Italy. 10. Hospital General Universitario de Elche, Elche, Spain. 11. North Bristol NHS Trust, Bristol, UK. 12. Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium. 13. Universitair Ziekenhuis Antwerpen, Antwerp, Belgium. 14. Universitätsklinikum, Essen, Germany. 15. Centre Hospitalier Universitaire, Nantes, France. 16. Medizinische Hochschule, Hannover, Germany. 17. ViiV Healthcare, Brentford, UK.
Abstract
BACKGROUND: Switching from boosted PIs to dolutegravir in people living with HIV (PLWH) with high cardiovascular risk improved plasma lipids at 48 weeks in the NEAT022 trial. Whether this strategy may have an impact on cardiovascular biomarkers is unknown. METHODS: We assessed 48 week changes in biomarkers associated with inflammation, endothelial dysfunction, monocyte immune activation, oxidation, insulin resistance, hypercoagulability, heart failure, myocardial injury, and glomerular and tubular kidney injury. RESULTS: Of 415 PLWH randomized in the NEAT022 study, 313 (75.4%) remained on allocated therapy and had paired samples available. Soluble CD14 (-11%, P < 0.001) and adiponectin (-11%, P < 0.001) significantly declined and high-sensitive C-reactive protein (-13%, P = 0.069) and oxidized LDL (-13%, P = 0.084) tended to decrease with dolutegravir. Switching to dolutegravir remained significantly associated with soluble CD14 and adiponectin reductions after adjustment for baseline variables. There were inverse correlations between soluble CD14 and CD4 count changes (P = 0.05), and between adiponectin and BMI changes (P < 0.001). CONCLUSIONS: Switching from boosted PIs to dolutegravir in PLWH with high cardiovascular risk led to soluble CD14 and adiponectin reductions at 48 weeks. While decreasing soluble CD14 may entail favourable health effects in PLWH, adiponectin reduction may reflect less insulin sensitivity associated with weight gain.
BACKGROUND: Switching from boosted PIs to dolutegravir in people living with HIV (PLWH) with high cardiovascular risk improved plasma lipids at 48 weeks in the NEAT022 trial. Whether this strategy may have an impact on cardiovascular biomarkers is unknown. METHODS: We assessed 48 week changes in biomarkers associated with inflammation, endothelial dysfunction, monocyte immune activation, oxidation, insulin resistance, hypercoagulability, heart failure, myocardial injury, and glomerular and tubular kidney injury. RESULTS: Of 415 PLWH randomized in the NEAT022 study, 313 (75.4%) remained on allocated therapy and had paired samples available. Soluble CD14 (-11%, P < 0.001) and adiponectin (-11%, P < 0.001) significantly declined and high-sensitive C-reactive protein (-13%, P = 0.069) and oxidized LDL (-13%, P = 0.084) tended to decrease with dolutegravir. Switching to dolutegravir remained significantly associated with soluble CD14 and adiponectin reductions after adjustment for baseline variables. There were inverse correlations between soluble CD14 and CD4 count changes (P = 0.05), and between adiponectin and BMI changes (P < 0.001). CONCLUSIONS: Switching from boosted PIs to dolutegravir in PLWH with high cardiovascular risk led to soluble CD14 and adiponectin reductions at 48 weeks. While decreasing soluble CD14 may entail favourable health effects in PLWH, adiponectin reduction may reflect less insulin sensitivity associated with weight gain.
Authors: Andrea De Vito; Annarita Botta; Marco Berruti; Valeria Castelli; Vincenzo Lai; Chiara Cassol; Alessandro Lanari; Giulia Stella; Adrian Shallvari; Antonia Bezenchek; Antonio Di Biagio Journal: J Pers Med Date: 2022-01-31