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Switching to dual/monotherapy determines an increase in CD8+ in HIV-infected individuals: an observational cohort study

Overview of attention for article published in BMC Medicine, May 2018
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Title
Switching to dual/monotherapy determines an increase in CD8+ in HIV-infected individuals: an observational cohort study
Published in
BMC Medicine, May 2018
DOI 10.1186/s12916-018-1046-2
Pubmed ID
Authors

Cristina Mussini, Patrizia Lorenzini, Alessandro Cozzi-Lepri, Giulia Marchetti, Stefano Rusconi, Andrea Gori, Silvia Nozza, Miriam Lichtner, Andrea Antinori, Andrea Cossarizza, Antonella d’Arminio Monforte

Abstract

The CD4/CD8 ratio has been associated with the risk of AIDS and non-AIDS events. We describe trends in immunological parameters in people who underwent a switch to monotherapy or dual therapy, compared to a control group remaining on triple antiretroviral therapy (ART). We included patients in Icona who started a three-drug combination ART regimen from an ART-naïve status and achieved a viral load ≤ 50 copies/mL; they were subsequently switched to another triple or to a mono or double regimen. Standard linear regression at fixed points in time (12-24 months after the switch) and linear mixed model analysis with random intercepts and slopes were used to compare CD4 and CD8 counts and their ratio over time according to regimen types (triple vs. dual and vs. mono). A total of 1241 patients were included; 1073 switched to triple regimens, 104 to dual (72 with 1 nucleoside reverse transcriptase inhibitor (NRTI), 32 NRTI-sparing), and 64 to monotherapy. At 12 months after the switch, for the multivariable linear regression the mean change in the log10 CD4/CD8 ratio for patients on dual therapy was -0.03 (95% confidence interval (CI) -0.05, -0.0002), and the mean change in CD8 count was +99 (95% CI +12.1, +186.3), taking those on triple therapy as reference. In contrast, there was no evidence for a difference in CD4 count change. When using all counts, there was evidence for a significant difference in the slope of the ratio and CD8 count between people who were switched to triple (points/year change ratio = +0.056, CD8 = -25.7) and those to dual regimen (ratio = -0.029, CD8 = +110.4). We found an increase in CD8 lymphocytes in people who were switched to dual regimens compared to those who were switched to triple. Patients on monotherapy did not show significant differences. The long-term implications of this difference should be ascertained.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 69 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 69 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 20%
Professor 9 13%
Other 6 9%
Student > Postgraduate 5 7%
Student > Master 5 7%
Other 15 22%
Unknown 15 22%
Readers by discipline Count As %
Medicine and Dentistry 25 36%
Immunology and Microbiology 5 7%
Biochemistry, Genetics and Molecular Biology 3 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 4%
Nursing and Health Professions 3 4%
Other 6 9%
Unknown 24 35%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 June 2018.
All research outputs
#10,441,186
of 13,691,544 outputs
Outputs from BMC Medicine
#2,009
of 2,159 outputs
Outputs of similar age
#189,008
of 271,946 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
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