Switching from boosted PIs to dolutegravir decreases soluble CD14 and adiponectin in high cardiovascular risk people living with HIV
Ana Gonzalez‐Cordón, Lambert Assoumou, Graeme Moyle, Laura Waters, Margaret Johnson, Peré Domingo, Julie Fox, Hans‐Jürgen Stellbrink, Giovanni Guaraldi, Mar Masiá, Mark Gompels, Stephane De Wit, Éric Florence, Stefan Eßer, François Raffi, Georg M. N. Behrens, Anton Pozniak, José M. Gatell, Estebán Martínez, the NEAT022 Study Group, Linos Vandekerckhove, Els Caluwé, Stephane De Wit, Coca Necsoi, Éric Florence, Maartje Van Frankenhuijsen, François Raffi, Clotilde Allavena, Véronique Reliquet, David Boutoille, Morane Cavellec, Elisabeth André‐Garnier, Audrey Rodallec, Thierry Le Tourneau, J. Connault, Jean‐Michel Molina, Samuel Ferret, Miresta Prévilon, Yazdan Yazdanpanah, Roland Landman, Véronique Joly, Adriana Pinto, Christine Katlama, Fabienne Caby, Nadine Ktorza, Luminita Schneider, Christoph Stephan, Timo Wolf, Gundolf Schüttfort, Juergen Rockstroh, Jan‐Christian Wasmuth, Carolynne Schwarze‐Zander, Christoph Boesecke, Hans‐Jürgen Stellbrink, Christian Hoffmann, Michael Sabranski, Stephan Esser, Robert Jablonka, Heidi Wiehler, Georg M. N. Behrens, Matthias Stoll, Gerrit Ahrenstorf, Giovanni Guaraldi, Giulia Nardini, Barbara Beghetto, Antonella D’Arminio Montforte, Teresa Bini, Viola Cogliandro, Massimo Di Pietro, Francesco Maria Fusco, Massimo Galli, Stefano Rusconi, Andrea Giacomelli, Paola Meraviglia, Estebán Martínez, Ana Gonzalez‐Cordón, José María Gatell, Berta Torres, Peré Domingo, Gràcia Mateo, Mar Gutierrez, Joaquín Portilla, Esperanza Merino, Sergio Reus, Vicente Boix, Mar Masiá, Félix Gutiérrez, Sergio Padilla, Bonaventura Clotet, Eugènia Negredo, Anna Bonjoch, José L. Casado, Sara Bañón-Escandell, José Sabán, Africa Duque, Daniel Podzamczer, María Saumoy, Laura Acerete, Juan González‐García, José Ignacio Bernardino
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.