Different Trends of Immune Activation Markers When Switching to Either Oral or Injectable Dual Antiretroviral Therapy Based on Integrase Inhibitors in People Living with HIV.

BACKGROUND

Despite improvements in life expectancy, people living with HIV (PWH) continue displaying immune activation and high rates of comorbid conditions. No comparative studies concerning activation markers exist between simplification strategies to either oral or long-acting (LA) dual ART.

METHODS

We prospectively collected plasma samples from PWH on successful ART, simplifying treatment from triple oral to either oral or LA dual ART based on integrase inhibitors. We measured changes in soluble CD14 (sCD14), soluble CD163 (sCD163), monocyte chemoattractant protein-1, and interleukin-6. Background measurements and markers of microbial translocation and gut integrity (I-FABP, LBP) were also collected.

RESULTS

From 2019 to 2023, 38 PWH were analyzed (mean age 52, 87% male, 21 years HIV diagnosis, CD4 730 cells/mm3, nadir CD4 317 cells/mm3, AIDS 13%). After 7.2 months, sCD14 trajectories differed according to regimen (+0.43 ng/mL, p = 0.033 for LA ART, -0.62 ng/mL, p < 0.001 for oral ART) but were not related to I-FABP or to LBP values. In case of CD4 nadir < 200 cc/mm3, AIDS, or very-low-level viremia, sCD163 values significantly increased when switching to oral but not to LA dual ART.

CONCLUSION

We found different trends in immune activation markers and risk factors associated with PWH switching to either oral or LA ART, requiring larger studies.