Switching from boosted PIs to dolutegravir decreases soluble CD14 and adiponectin in high cardiovascular risk people living with HIV
Author:
González-Cordón Ana1, Assoumou Lambert2, Moyle Graeme3, Waters Laura4, Johnson Margaret5, Domingo Pere6ORCID, Fox Julie7, Stellbrink Hans-Jürgen8, Guaraldi Giovanni9ORCID, Masiá Mar10ORCID, Gompels Mark11, De Wit Stephane12, Florence Eric13, Esser Stefan14, Raffi François15, Behrens Georg16, Pozniak Anton3, Gatell José M.117, Martínez Esteban1, Vandekerckhove Linos, Caluwé Els, De Wit Stephane, Necsoi Coca, Florence Eric, Van Frankenhuijsen Maartje, Raffi François, Allavena Clotilde, Reliquet Véronique, Boutoille David, Cavellec Morane, André-Garnier Elisabeth, Rodallec Audrey, Le Tourneau Thierry, Connault Jérôme, Molina Jean-Michel, Ferret Samuel, Previlon Miresta, Yazdanpanah Yazdan, Landman Roland, Joly Véronique, Pinto Adriana, Katlama Christine, Caby Fabienne, Ktorza Nadine, Schneider Luminita, Stephan Christoph, Wolf Timo, Schüttfort Gundolf, Rockstroh Juergen, Wasmuth Jan-Christian, Schwarze-Zander Carolynne, Boesecke Christoph, Stellbrink Hans-Jurgen, Hoffmann Christian, Sabranski Michael, Esser Stephan, Jablonka Robert, Wiehler Heidi, Behrens Georg, Stoll Matthias, Ahrenstorf Gerrit, Guaraldi Giovanni, Nardini Giulia, Beghetto Barbara, Montforte Antonella D’Arminio, Bini Teresa, Cogliandro Viola, Di Pietro Massimo, Fusco Francesco Maria, Galli Massimo, Rusconi Stefano, Giacomelli Andrea, Meraviglia Paola, Martinez Esteban, González-Cordón Ana, Gatell José Maria, Torres Berta, Domingo Pere, Mateo Gracia, Gutierrez Mar, Portilla Joaquin, Merino Esperanza, Reus Sergio, Boix Vicente, Masia Mar, Gutiérrez Félix, Padilla Sergio, Clotet Bonaventura, Negredo Eugenia, Bonjoch Anna, Casado José L, Bañón-Escandell Sara, Saban Jose, Duque Africa, Podzamczer Daniel, Saumoy Maria, Acerete Laura, Gonzalez-Garcia Juan, Bernardino José Ignacio, Arribas José Ramón, Hontañón Victor, Moyle Graeme, Pagani Nicole, Bracchi Margherita, Vera Jaime, Clarke Amanda, Adams Tanya, Richardson Celia, Winston Alan, Mora-Peris Borja, Mullaney Scott, Waters Laura, de Esteban Nahum, Milinkovic Ana, Pett Sarah, Fox Julie, Tiraboschi Juan Manuel, Johnson Margaret, Youle Mike, Orkin Chloe, Rackstraw Simon, Hand James, Gompels Mark, Jennings Louise, Nicholls Jane, Johnston Sarah,
Affiliation:
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
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.
Funder
NEAT-ID Foundation SSAT and ViiV Healthcare Spanish centres and Spanish Plan Nacional I + D+i and co-funded by the Spanish Instituto de Salud Carlos III (ISCIII) – Subdirección General de Evaluación and European Regional Development Fund
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)
Cited by
16 articles.
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