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Gonzalez-Serna A, Ferrando-Martinez S, Tarancon-Diez L, De Pablo-Bernal RS, Dominguez-Molina B, Jiménez JL, Muñoz-Fernández MÁ, Leal M, Ruiz-Mateos E. Increased CD127+ and decreased CD57+ T cell expression levels in HIV-infected patients on NRTI-sparing regimens. J Transl Med 2017; 15:259. [PMID: 29262860 PMCID: PMC5738860 DOI: 10.1186/s12967-017-1367-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/12/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND NRTIs-sparing regimens exert favourable profiles on T-cell homeostasis associated parameters. Our aim was to analyze the effect of NRTIs sparing regimen (NRTI-sparing-cART) vs NRTIs-containing regimen (NRTI-cART), on T-cell homeostasis associated parameters in naive HIV-infected patients. METHODS Biomarkers of cell survival (CD127) and replicative senescence (CD57), were measured by multiparametric flow cytometry for T-cell phenotyping on peripheral blood mononuclear cells (PBMCs) samples just before (baseline) and after 48 weeks of undetectable viral load in patients on NRTI-sparing-cART (N = 13) and NRTI-cART (N = 14). After 48 weeks a subgroup of patients (n = 5) on NRTI-cART switched to NRTI-sparing-cART for another additional 48 weeks. In vitro assays were performed on PBMCs from HIV-uninfected healthy donors exposed or not to HIV. To analyze the independent factors associated with type of cART bivariate and stepwise multivariate analysis were performed after adjusting for basal CD4+, CD8+ and nadir CD4+ T-cell counts. RESULTS After 48 weeks of a NRTI-sparing-cART vs NRTI-cART patients have higher effector memory (EM) CD4+ CD127+ T-cell levels, lower EM CD4+ CD57+ T-cell levels, higher CD8+ CD127+ T-cell levels, lower CD8+ CD57+ T-cell levels and higher memory CD8+ T-cell levels. This effect was confirmed in the subgroup of patients who switched to NRTI-sparing-cART. In vitro assays confirmed that the deleterious effect of a NRTIs-containing regimen was due to NRTIs. CONCLUSIONS The implementation of NRTI-sparing regimens, with a favourable profile in CD127 and CD57 T-cell expression, could benefit cART-patients. These results could have potential implications in a decrease in the number of Non-AIDS events.
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Affiliation(s)
- A Gonzalez-Serna
- Molecular Immunobiology Laboratory, Health Research Institute Gregorio Marañon, Spanish HIV HGM BioBank, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), General Universitary Hospital Gregorio Marañon, C/Dr. Esquerdo 46, 28007, Madrid, Spain. .,Viral and Immune Infection Unit Center, Institute of Health Carlos III, Molecular Immunobiology Laboratory, General Universitary Hospital Gregorio Marañon, Majadahonda Campus, Madrid, Spain.
| | - S Ferrando-Martinez
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain
| | - L Tarancon-Diez
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain
| | - R S De Pablo-Bernal
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain
| | - B Dominguez-Molina
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain
| | - J L Jiménez
- Molecular Immunobiology Laboratory, Health Research Institute Gregorio Marañon, Spanish HIV HGM BioBank, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), General Universitary Hospital Gregorio Marañon, C/Dr. Esquerdo 46, 28007, Madrid, Spain.,Viral and Immune Infection Unit Center, Institute of Health Carlos III, Molecular Immunobiology Laboratory, General Universitary Hospital Gregorio Marañon, Majadahonda Campus, Madrid, Spain
| | - M Á Muñoz-Fernández
- Molecular Immunobiology Laboratory, Health Research Institute Gregorio Marañon, Spanish HIV HGM BioBank, Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), General Universitary Hospital Gregorio Marañon, C/Dr. Esquerdo 46, 28007, Madrid, Spain.,Viral and Immune Infection Unit Center, Institute of Health Carlos III, Molecular Immunobiology Laboratory, General Universitary Hospital Gregorio Marañon, Majadahonda Campus, Madrid, Spain
| | - M Leal
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain
| | - E Ruiz-Mateos
- Laboratory of Immunovirology, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, C/Avenida Manuel Siurot s/n, 41013, Seville, Spain. .,Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, Centro Superior de Investigaciones Científicas, Seville, Spain.
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Abstract
OBJECTIVE(S) To examine the impact of ribavirin and abacavir coadministration on hepatitis C virus (HCV) virological response and trough ribavirin plasma concentration (Cmin) in HIV-HCV coinfected patients. DESIGN Pharmacokinetic substudy on patients from the ANRS CO-13 HEPAVIH cohort. METHODS Patients receiving ribavirin-pegylated interferon for whom a ribavirin steady state Cmin was prospectively determined were included. Rapid virological response (RVR), early virological response (EVR) and sustained virological response (SVR) as well as HCV-RNA decline were evaluated. RESULTS Overall, 124 HIV-HCV coinfected patients (95% on antiretroviral therapy) were enrolled. Of these patients, 22% received abacavir. The overall median (interquartile range) ribavirin Cmin was 1.6 mg/l (1.2-2.2) with no statistical difference between abacavir users and nonusers [1.5 mg/l (0.99-2.1) and 1.7 (1.2-2.3), P = 0.15]. RVR and EVR were 52 and 72%, respectively. There was no difference observed in the proportion of abacavir users vs. nonusers achieving RVR (respectively 59 vs. 50%, P = 0.40) or EVR (72 vs. 73%, P = 0.94), or in the HCV-RNA decline at week 4 [-2.24 log(10) IU/ml, (-3.58; -0.81) and -1.27 (-2.8; -0.47) P = 0.28] or at week 12 [-1.76 log(10) IU/ml (-3.67; -0.35) and -1.85 (-3.13; -1.13) (P = 0.58)]. The SVR rate was 45% for abacavir users and 24% for abacavir nonusers, but the difference was not statistically significant (P = 0.059). CONCLUSION In our study, there was no evidence that abacavir affected HCV treatment outcomes and the ribavirin Cmin was similar in abacavir users and nonusers, confirming the absence of pharmacokinetic interaction between abacavir and ribavirin. An abacavir-containing regimen is, therefore, a well tolerated treatment alternative for coinfected patients starting HCV treatment.
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