期刊
JOURNAL OF INFECTIOUS DISEASES
卷 218, 期 10, 页码 1523-1530出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiy399
关键词
HIV infection; antiretroviral therapy; darunavir/ritonavir; raltegravir; tenofovir; telomere length; telomerase
资金
- NEAT-ID Foundation
- Red Tematica Cooperativa de Investigacion en Sida
- Fondo de Investigaciones Sanitarias - FEDER funds [PI13/01467]
- RioHortega fellowship
- Gilead Sciences
- Janssen Pharmaceuticals
- Merck Laboratories
- French National Institute for Health and Medical Research-France Recherche Nord and Sud Sida-HIV Hepatites (Inserm-ANRS)
Background. Tenofovir is a potent inhibitor of human telomerase. The clinical relevance of this inhibition is unknown. Methods. NEAT001/ANRS143 is a randomized trial that showed noninferiority over 96 weeks of ritonavir-boosted darunavir plus raltegravir versus tenofovir disoproxil fumarate/emtricitabine in 805 antiretroviral antiretrovrial-naive HIV-infected adults. We compared changes in whole-blood telomere length measured with quantitative polymerase chain reaction in 201 randomly selected participants (104 raltegravir and 97 tenofovir disoproxil fumarate/emtricitabine). We performed multivariable estimative and predictive linear regression. Results. At week 96, participants receiving tenofovir disoproxil fumarate/emtricitabine had a statistically significant higher gain in telomere length than participants receiving raltegravir. Difference in mean telomere length change between groups (tenofovir disoproxil fumarate/emtricitabine minus raltegravir) from baseline to week 96 adjusted by baseline telomere length was 0.031 (P = .009). This difference was not significantly confounded by age, gender, known duration of HIV infection, CD4 (baseline/nadir), CD8 cells, CD4/CD8 ratio, HIV viral load (baseline/week 96), tobacco and alcohol consumption, statins, or hepatitis C. Conclusion. Antiretroviral-naive HIV-infected adults receiving ritonavir-boosted darunavir and tenofovir disoproxil fumarate/emtricitabine had a significant higher gain in blood telomere length than those receiving ritonavir-boosted darunavir and raltegravir, suggesting a better initial recovery from HIV-associated immunosenescence.
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