Changes in Inflammatory Biomarkers When Switching from Three-Drug Regimens to Dolutegravir Plus Lamivudine in People Living with HIV

Abstract

It is not clear if there is a difference between 3-drug regimens (3DR) and 2-drug regimens (2DR) in terms of suppression of chronic inflammation. We compared CRP, CD4+/CD8+ ratio, lipid proliges measured in daily clinical practice before and after the switch to dolutegravir plus lamivudine (DTG/3TC) to examine the difference in the anti-inflammatory effect of 3DR and 2DR. In this single-center, retrospective, observational study, individuals who were on abacavir/lamivudine/dolutegravir (ABC/3TC/DTG), Tenofovir alafenamide/emtricitabine (TAF/FTC) plus DTG, or bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) prior to switching to DTG/3TC, were eligible. A total of 119 individuals were enrolled in the study. The median (IQR) time since diagnosis of HIV infection was 12 (7-16) years. Overall, inflammation markers such as CD4+/CD8+ ratio, CD4+, CRP and lipid profiles did not change. Analysis of only individuals who switched from ABC/3TC/DTG, TAF-based regimens also showed no significant changes in inflammatory markers. Since viremia raises inflammatory markers, differences in antiviral efficacy may make a difference in the suppression of chronic inflammation but in conclusion, we did not find any change in inflammatory markers by changing from 3DR to 2DR in daily clinical practice.