Comparison of Three Different Anti-retroviral Regimens in Terms of Immunological and Virological Response

Abstract

Introduction: After introduction of highly active anti-retroviral treatment (HAART), the mortality and morbidity rates among HIV/AIDS patients have been reduced. CD4+ T cell and HIV RNA measurement is important in the follow-up during the treatment. The aim of this study was to evaluate three different ART regimens in terms of immunological and virological response. Materials and Methods: The study was designed as a retrospective cohort study. Treatment-naive adult HIV/AIDS patients who applied to our outpatient clinic between 2011 and 2017 were included in this study. Treatment regimens included two nucleoside reverse transcriptase inhibitors (NRTI) with either one of a non-nucleoside reverse transcriptase inhibitor (NNRTI) or integrase inhibitor (INI) or protease inhibitor (PI). CD4+ T cell counts and HIV RNA levels were analysed at 1st month, 3rd month, 6th month and 12th month. Results: Sixty-three patients (87% were male) aged 43±13 (min 19, max 66 ) years were included in this study. Fourteen (22.2%) received NRTI and INI treatment (INI group), 18 (28.6%) received NRTI and PI (PI group) and 31 (49.2%) received NRTI and NNRTI (NNRTI group). Immunologically, the PI group was the most successful while NNRTI group was the least successful. INI group had significantly higher immunological response rate than NNRTI group in the first three months. The treatment was more successful in INI group in terms of virological response than in PI and NNRTI groups in the first three months. However, at the end of 6 and 12 months, no statistically significant difference was observed between the groups, neither immunologically nor virologically. Conclusion: Our results have shown that all regimens were effective at the end of 12 months. Among the combinations available, the most appropriate one should be selected individually.

Keywords

• CD4
• virological
• immunological
• anti-retroviral treatment
• dolutegravir