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Elvitegravir Reduces Monocyte Activation and Vascular Inflammation More than Efavirenz
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Reported by Jules Levin
CROI 2015 Feb 23-26, Seattle, WA
Corrilynn O Hileman1,3, Bruce Kinley2,3, Valeska Scharen-Guivel4, Kathy Melbourne4, Javier Szwarcberg4, Janet Robinson2,3, Michael M Lederman2,3 and Grace A McComsey2,3
1MetroHealth Medical Center, 2University Hospitals Case Medical Center, 3Case Western Reserve University School of Medicine, Cleveland, OH, 4Gilead Sciences, Foster City, CA
http://www.natap.org/2014/HIV/012114_02.htm......Associations of Inflammatory Markers With AIDS and Non-AIDS Clinical Events After Initiation of Antiretroviral Therapy: AIDS Clinical Trials Group A5224s, a Substudy of ACTG A5202......"higher pre-ART and on-ART levels of several inflammatory biomarkers were associated independently of CD4 count with increased risk of progression to AIDS and/or non-AIDS events"
Inflammation in Chronic HIV Infection: What can we do? Author findings suggest integrase inhibitors have benefits.....http://www.natap.org/2014/HIV/012215_01.htm......"We show here that over 48 weeks, changes in sCD14, hsCRP and Lp-PLA2 favor EVG/c/FTC/TDF over EFV/FTC/TDF......"At baseline, markers of monocyte activation, systemic and vascular inflammation were similar between-groups. Baseline, week 24, week 48 and absolute changes from baseline to week 24 and to week 48 in all markers are shown in Table 2. Within the EVG/c/FTC/TDF group, all markers decreased significantly relative to baseline by week 48 with the exception of Lp-PLA2 which neared significance (p=0.06 within-group). In the EFV/FTC/TDF group, the changes were mixed."
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"changes over 24 and 48 weeks in biomarkers of monocyte activation (sCD14, sCD163), systemic (sTNF-RI, IL-6, hsCRP) and vascular inflammation (Lp-PLA2) were compared."
program abstract: Weight, lipid and CD4 changes were similar between groups. The 48 week changes in sCD14 and Lp-PLA2 remained significantly different between groups after adjustment for changes in all clinically important variables (p2 were baseline Lp-PLA2, LDL-cholesterol and IL-6, and changes in cholesterol, triglycerides, sCD14 and sCD163.
Conclusions: Initiation of ART with EVG/C/F/TDF led to greater decreases in sCD14 and Lp-PLA2 when compared with EFV/F/TDF. Randomization group independently predicted changes in sCD14, and changes in monocyte activation independently predicted changes in Lp-PLA2. There appears to be a different effect of the integrase inhibitor EVG compared to EFV on HIV-related immune activation which may in turn impact vascular inflammation.
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