scholarly journals Gradually increased dyslipidemia  in human immunodeficiency virus infected male patients with tenofovir plus lamivudine plus efavirenz primary treatment: a 3-year follow-up study

2020 ◽  
Author(s):  
dafeng liu ◽  
Bennan Zhao ◽  
Xinyi Zhang ◽  
Fengjiao Gao ◽  
Jun Kang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Cd4 T Cell ◽  
Infected Male ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Male Patients ◽  
Cd4 T Cell Count

Abstract IntroductionSince the start of highly active antiretroviral therapy (HAART) with TDF plus 3TC plus EFV, the long-term dynamic characteristics of lipid and purine metabolism in patients infected with human immunodeficiency virus (HIV) was unclear and worth studying.MethodsA prospective follow-up cohort study was the way. Sixty-one treatment-naive HIV infected male patients were divided into three groups based on the baseline CD4 + T cell count (26, 12, 23cases in < 200, from 200 to 350, > 350 three groups, respectively). Lipid and purine metabolism parameters of those patients within 144 weeks were analyzed.ResultTG, TC, LDL-c and HDL-c level all gradually increased within 144 weeks, but statistical significances of TC level and HDL-c level were only found (F = 4.214, 5.518, P = 0.001, 0.000 ,respectively). Moreover the percentage of hypercholesterolemia, hyper LDL cholesterolemia and hypertriglyceridemia all gradually increased, low HDL cholesterolemia gradually decreased, but there was only obvious difference of the latter (χ2 = 16.105, P = 0.0007).Furthermore the lower the baseline CD4 + T lymphocyte counts, the higher TG level, the lower TC level, LDL-c level and HDL-c level, but only significant difference of LDL-c level between three groups at baseline was found (F = 3.256,P = 0.0457).Although UA level and the percentages of hyperuricemia gradually increased within 144 weeks, but there was no significant difference between different follow-up time points groups and between three CD4 + T cell count groups (all P༞0.05).ConclusionsThese findings provide a reference for clinicians to monitor lipid metabolism parameters closely during long-term HAART with TDF plus 3TC plus EFV regimen.

scholarly journals Gradual increases in dyslipidemia among male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz: a 3-year follow-up study

2021 ◽  
Author(s):  
dafeng liu ◽  
Xingyi ZHANG ◽  
Jun Kang ◽  
Fengjiao Gao ◽  
Yinsheng He ◽  
...  
Keyword(s):  
Lipid Metabolism ◽  
T Cell ◽  
Cell Count ◽  
Cd4 T Cell ◽  
Anthropometric Parameters ◽  
Significant Difference ◽  
Male Patients ◽  
Cd4 T Cell Count

Abstract Introduction: Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric monitoring.Methods: A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with HIV were divided into three groups based on their baseline CD4+ T cell count (26, 12, and 23 patients in the <200, 200 to 350, and >350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.Result: TG, TC, LDL-c and HDL-c levels all gradually increased over 144 weeks, but the increases in TC levels and HDL-c levels were significant (P=0.001, 0.000, respectively). Moreover, the percentages of hypercholesterolemia, hyper LDL cholesterolemia and hypertriglyceridemia all showed gradual and nonsignificant increases; the percentage of low HDL cholesterolemia showed a gradual and significant decrease (P=0.0007). Furthermore, the lower the baseline CD4+ T lymphocyte counts were, the higher the TG levels were and the lower the TC, LDL-c and HDL-c levels were. However, only baseline LDL-c levels differed significantly between the three groups (P=0.0457). Although the UA level and the percentages of hyperuricemia gradually increased over 144 weeks, there was no significant difference between the different follow-up time point groups or between the three CD4+ T cell count groups (all P>0.05). Further analyses revealed that the main factors contributing to lipid metabolism were age, anthropometric parameters and follow-up weeks, and virus load was the main factor contributing to uric acid levels.Conclusions: These findings provide a reference for clinicians to monitor lipid metabolism parameters closely during long-term ART with the TDF plus 3TC plus EFV regimen.

scholarly journals Even Individuals Considered as Long-Term Nonprogressors Show Biological Signs of Progression After 10 Years of Human Immunodeficiency Virus Infection

Blood ◽  
1997 ◽  
Vol 90 (3) ◽  
pp. 1133-1140 ◽  
Author(s):  
Jean-Jacques Lefrère ◽  
Laurence Morand-Joubert ◽  
Martine Mariotti ◽  
Hubertus Bludau ◽  
Béatrice Burghoffer ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Copy Number ◽  
Cd4 T Cell ◽  
Viral Copy Number ◽  
Immunodeficiency Virus ◽  
Viral Copy ◽  
Cd4 T Cell Count

Abstract Despite a decade of human immunodeficiency virus (HIV) seropositivity, a few individuals termed as long-term nonprogressors (LTNPs) maintain a stable CD4+ T-cell count for a period of time. The aim of this study was to establish, through the sequential determination of all known predictors of HIV disease, the proportion of such patients having stringent criteria of true long-term nonprogression. Among 249 individuals who were HIV-infected and prospectively followed up over a 10-year period (1985 to 1995), 12 having a CD4+ T-cell count greater than 500/μL (LTNP I group) and 9 having a CD4+ T-cell count less than 500 but stable over time (LTNP II group) after at least 10 years of infection without intervention of antiviral therapy, were studied over the entire follow-up period. The plasma HIV RNA copy number and the serum concentrations of p24 antigen, each anti-HIV antibody, neopterin, β-2-microglobulin, Immunoglobulin (Ig) G and IgA were determined every 18 months over the study period. Cellular and plasma viremias were cross-sectionaly assayed in all 21 patients. Only two patients had strictly no marker of progression over the follow-up period. They were the only ones who had, over the 10-year period, a viral copy number too low to be detected. The other patients had a viral copy number higher than 400/mL at at least one visit and increasing over the follow-up period, and they evidenced one or more markers of virological or immunological deterioration. Cellular viremia was positive in all patients but two, while plasma viremia was negative in all but one. The population of individuals termed as LTNPs is not virologically and immunologically homogeneous. The majority present biological signs of HIV disease progression. A new pattern of true LTNP can be drawn through stringent criteria based on the whole known predictors. This pattern appears to be rare in HIV-positive population.

scholarly journals Gradual Increasing Dyslipidemia in Male Patients With Human Immunodeficiency Virus Primarily Treated With Tenofovir Plus Lamivudine Plus Efavirenz for Three Years

2021 ◽  
Author(s):  
Dafeng Liu ◽  
Xinyi Zhang ◽  
Jun Kang ◽  
Fengjiao Gao ◽  
Yinsheng He ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Anthropometric Parameters ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Male Patients ◽  
Cd4 Cell

Abstract Introduction: Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric acid monitoring.Methods: A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with human immunodeficiency virus (HIV) were divided into three groups based on their baseline CD4+ cell count (26, 12, and 23 patients in the <200, 200 to 350, and >350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.Result: Within 144 weeks, TG, LDL-c, TC and HDL-c gradually increased, especially the latter two (P=0.001, 0.000, respectively). Moreover, the percentages of hypercholesterolemia, hyper LDL cholesterolemia, hypertriglyceridemia and low HDL cholesterolemia also gradually increased, especially the latter (P=0.0007). The lower the baseline CD4+ cell counts were, the higher the TG levels were and the lower the TC, LDL-c and HDL-c levels were. But there was significant difference of only baseline LDL-c levels between the three groups (P=0.0457). No significant difference of the UA level and the percentages of hyperuricemia was found between the different follow-up time point groups or between the three groups (all P>0.05). The risk factors for dyslipidemia included age, anthropometric parameters and follow-up weeks, and for hyperuricemia was virus load.Conclusions: Gradual increasing dyslipidemia was found in male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz for three years. There-fore lipid metabolism parameters should be closely monitored during long-term ART with the TDF plus 3TC plus EFV regimen.

scholarly journals Even Individuals Considered as Long-Term Nonprogressors Show Biological Signs of Progression After 10 Years of Human Immunodeficiency Virus Infection

Blood ◽  
1997 ◽  
Vol 90 (3) ◽  
pp. 1133-1140 ◽  
Author(s):  
Jean-Jacques Lefrère ◽  
Laurence Morand-Joubert ◽  
Martine Mariotti ◽  
Hubertus Bludau ◽  
Béatrice Burghoffer ◽  
...  
Keyword(s):  
T Cell ◽  
Cell Count ◽  
Copy Number ◽  
Cd4 T Cell ◽  
Viral Copy Number ◽  
Immunodeficiency Virus ◽  
Viral Copy ◽  
Cd4 T Cell Count

Despite a decade of human immunodeficiency virus (HIV) seropositivity, a few individuals termed as long-term nonprogressors (LTNPs) maintain a stable CD4+ T-cell count for a period of time. The aim of this study was to establish, through the sequential determination of all known predictors of HIV disease, the proportion of such patients having stringent criteria of true long-term nonprogression. Among 249 individuals who were HIV-infected and prospectively followed up over a 10-year period (1985 to 1995), 12 having a CD4+ T-cell count greater than 500/μL (LTNP I group) and 9 having a CD4+ T-cell count less than 500 but stable over time (LTNP II group) after at least 10 years of infection without intervention of antiviral therapy, were studied over the entire follow-up period. The plasma HIV RNA copy number and the serum concentrations of p24 antigen, each anti-HIV antibody, neopterin, β-2-microglobulin, Immunoglobulin (Ig) G and IgA were determined every 18 months over the study period. Cellular and plasma viremias were cross-sectionaly assayed in all 21 patients. Only two patients had strictly no marker of progression over the follow-up period. They were the only ones who had, over the 10-year period, a viral copy number too low to be detected. The other patients had a viral copy number higher than 400/mL at at least one visit and increasing over the follow-up period, and they evidenced one or more markers of virological or immunological deterioration. Cellular viremia was positive in all patients but two, while plasma viremia was negative in all but one. The population of individuals termed as LTNPs is not virologically and immunologically homogeneous. The majority present biological signs of HIV disease progression. A new pattern of true LTNP can be drawn through stringent criteria based on the whole known predictors. This pattern appears to be rare in HIV-positive population.

scholarly journals Anti-cytomegalovirus Immunoglobulin G Is Linked to CD4 T-cell Count Decay in Human Immunodeficiency Virus (HIV) Elite Controllers

2020 ◽  
Author(s):  
Stephane Isnard ◽  
Rayoun Ramendra ◽  
John Lin ◽  
Sanket Kant ◽  
Brandon Fombuena ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Cell Count ◽  
Immunoglobulin G ◽  
Human Leukocyte ◽  
Cd4 T Cell ◽  
Elite Controllers ◽  
Leukocyte Antigen ◽  
Immunodeficiency Virus ◽  
Cd4 T Cell Count

Abstract Elite controllers (ECs) are people living with human immunodeficiency virus (HIV) who spontaneously control viral replication without antiretroviral therapy. We observed that elevated anti-cytomegalovirus (CMV) immunoglobulin G (IgG) levels correlated with annual CD4 T-cell count decay in ECs independently of age, sex, and human leukocyte antigen (HLA) type. Elevated anti-CMV titers may favor disease progression in ECs.

scholarly journals Longitudinal variation in human immunodeficiency virus long terminal repeat methylation in individuals on suppressive antiretroviral therapy

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
César N. Cortés-Rubio ◽  
Gonzalo Salgado-Montes de Oca ◽  
Francisco J. Prado-Galbarro ◽  
Margarita Matías-Florentino ◽  
Akio Murakami-Ogasawara ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cells ◽  
T Cell ◽  
Long Terminal Repeat ◽  
Clinical Characteristics ◽  
Short Term ◽  
Methylation Index ◽  
Immunodeficiency Virus

Abstract Background Persistence of latent, replication-competent provirus in CD4+ T cells of human immunodeficiency virus (HIV)-infected individuals on antiretroviral treatment (ART) is the main obstacle for virus eradication. Methylation of the proviral 5′ long terminal repeat (LTR) promoter region has been proposed as a possible mechanism contributing to HIV latency; however, conflicting observations exist regarding its relevance. We assessed 5′-LTR methylation profiles in total CD4+ T cells from blood of 12 participants on short-term ART (30 months) followed up for 2 years, and a cross-sectional group of participants with long-term ART (6–15 years), using next generation sequencing. We then looked for associations between specific 5′-LTR methylation patterns and baseline and follow-up clinical characteristics. Results 5′-LTR methylation was observed in all participants and behaved dynamically. The number of 5′-LTR variants found per sample ranged from 1 to 13, with median sequencing depth of 16270× (IQR 4107×-46760×). An overall significant 5′-LTR methylation increase was observed at month 42 compared to month 30 (median CpG Methylation Index: 74.7% vs. 0%, p = 0.025). This methylation increase was evident in a subset of participants (methylation increase group), while the rest maintained fairly high and constant methylation (constant methylation group). Persons in the methylation increase group were younger, had higher CD4+ T cell gain, larger CD8% decrease, and larger CD4/CD8 ratio change after 48 months on ART (all p < 0.001). Using principal component analysis, the constant methylation and methylation increase groups showed low evidence of separation along time (factor 2: p = 0.04). Variance was largely explained (21%) by age, CD4+/CD8+ T cell change, and CD4+ T cell subpopulation proportions. Persons with long-term ART showed overall high methylation (median CpG Methylation Index: 78%; IQR 71–87%). No differences were observed in residual plasma viral load or proviral load comparing individuals on short-term (both at 30 or 42 months) and long-term ART. Conclusions Our study shows evidence that HIV 5′-LTR methylation in total CD4+ T cells is dynamic along time and that it can follow different temporal patterns that are associated with a combination of baseline and follow-up clinical characteristics. These observations may account for differences observed between previous contrasting studies.

scholarly journals Continued Elevation of Interleukin-18 and Interferon-γ After Initiation of Antiretroviral Therapy and Clinical Failure in a Diverse Multicountry Human Immunodeficiency Virus Cohort

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Ashwin Balagopal ◽  
Nikhil Gupte ◽  
Rupak Shivakoti ◽  
Andrea L. Cox ◽  
Wei-Teng Yang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
Interferon Γ ◽  
Cd4 T Cell ◽  
Clinical Failure ◽  
Immunodeficiency Virus ◽  
Ifn Γ ◽  
Cd4 T Cell Count

Abstract Background.  We assessed immune activation after antiretroviral therapy (ART) initiation to understand clinical failure in diverse settings. Methods.  We performed a case-control study in ACTG Prospective Evaluation of Antiretrovirals in Resource-Limited Settings (PEARLS). Cases were defined as incident World Health Organization Stage 3 or 4 human immunodeficiency virus (HIV) disease or death, analyzed from ART weeks 24 (ART24) to 96. Controls were randomly selected. Interleukin (IL)-6, interferon (IFN)-γ-inducible protein-10, IL-18, tumor necrosis factor-α, IFN-γ, and soluble CD14 (sCD14) were measured pre-ART and at ART24 in plasma. Continued elevation was defined by thresholds set by highest pre-ART quartiles (&gt;Q3). Incident risk ratios (IRRs) for clinical progression were estimated by Poisson regression, adjusting for age, sex, treatment, country, time-updated CD4+ T-cell count, HIV ribonucleic acid (RNA), and prevalent tuberculosis. Results.  Among 99 cases and 234 controls, median baseline CD4+ T-cell count was 181 cells/µL, and HIV RNA was 5.05 log10 cp/mL. Clinical failure was independently associated with continued elevations of IL-18 (IRR, 3.03; 95% confidence interval [CI], 1.27–7.20), sCD14 (IRR, 2.17; 95% CI, 1.02–4.62), and IFN-γ (IRR, 0.08; 95% CI, 0.01–0.61). Among 276 of 333 (83%) who were virologically suppressed at ART24, IFN-γ was associated with protection from failure, but the association with sCD14 was attenuated. Conclusions.  Continued IL-18 and sCD14 elevations were associated with clinical ART failure. Interferon-γ levels may reflect preserved immune function.

scholarly journals Physician Decisions to Defer Antiretroviral Therapy in Key Populations: Implications for Reducing Human Immunodeficiency Virus Incidence and Mortality in Malaysia

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Enrico G. Ferro ◽  
Gabriel J. Culbert ◽  
Jeffrey A. Wickersham ◽  
Ruthanne Marcus ◽  
Alana D. Steffen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
T Cell ◽  
Antiretroviral Therapy ◽  
Cell Count ◽  
People Who Inject Drugs ◽  
Cd4 T Cell ◽  
Key Populations ◽  
Incidence And Mortality ◽  
Immunodeficiency Virus ◽  
Cd4 T Cell Count

Abstract Background Antiretroviral therapy (ART) is recommended for all people living with human immunodeficiency virus (HIV), yet physician attitudes and prescribing behaviors toward members of key risk populations may limit ART access and undermine treatment as prevention strategies. Methods Physicians in Malaysia (N = 214) who prescribe antiretroviral therapy (ART) responded in an Internet-based survey to hypothetical clinical scenarios of HIV patients, varying by key risk population and CD4+ T-cell count, on whether they would initiate or defer ART compared with a control patient with sexually acquired HIV. Results The proportion of physicians who would defer ART in patients with advanced HIV (CD4 = 17 cells/μL) was significantly higher (P &lt; .0001) for 4 key populations, including people who inject drugs ([PWID] 45.3%) or consume alcohol (42.1%), released prisoners (35.0%), and those lacking social support (26.6%), compared with a control patient (4.2%). People who inject drugs with advanced HIV (CD4 = 17 cells/μL) were 19-fold (adjusted odds ratio [AOR] = 18.9; 95% confidence interval [CI], 9.8–36.5) more likely to have ART deferred compared with the control. This effect was partially mitigated for PWID receiving methadone (AOR = 2.9; 95% CI, 1.5–5.7). At the highest CD4+ T-cell count (CD4 = 470 cells/μL), sex workers (AOR = 0.55; 95% CI, .44–.70) and patients with an HIV-uninfected sexual partner (AOR = 0.43; 95% CI, .34–.57) were significantly less likely to have ART deferred. Conclusions Physicians who prescribe antiretroviral therapy in Malaysia may defer ART in some key populations including PWID and released prisoners, regardless of CD4+ T-cell count, which may help to explain very low rates of ART coverage among PWID in Malaysia. Reducing HIV incidence and mortality in Malaysia, where HIV is concentrated in PWID and other key populations, requires clinician-level interventions and monitoring physician adherence to international evidence-based treatment guidelines.

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