Systemic inflammation markers after simplification to atazanavir/ritonavir plus lamivudine in virologically suppressed HIV-1-infected patients: ATLAS-M substudy

S Belmonti, F Lombardi, E Quiros-Roldan, A Latini, A Castagna, A Borghetti, G Baldin, A Ciccullo, R Cauda, A De Luca, S Di Giambenedetto, on behalf of the ATLAS-M Study Group

Research output: Contribution to journalArticle

Abstract

Background: Biomarkers of systemic inflammation predict non-AIDS events and overall mortality in virologically suppressed HIV-1-infected patients. Objectives: To determine whether switching to a dual antiretroviral maintenance therapy was associated with modification of biomarkers of systemic inflammation as compared with continuation of successful standard triple therapy. Methods: In this substudy of the randomized ATLAS-M trial, we compared in virologically suppressed patients the impact at 1 year of simplification to a dual therapy with atazanavir/ritonavir plus lamivudine versus maintaining atazanavir/ritonavir plus two NRTI triple therapy on markers of systemic inflammation. Plasma levels of interleukin-6, C-reactive protein (CRP), soluble CD14 (sCD14) and D-dimerwere quantified by ELISA at baseline and at 48weeks. Results: A subset of 139 of 266 randomized patients with available samples was analysed: 69 in the triple therapy arm and 70 in the dual therapy arm. The baseline biomarker levels were comparable between randomization arms. No significant differences in changes from baseline to week 48 were observed between arms (dual therapy versus triple therapy): IL-6, -0.030 versus -0.016 log10pg/L; CRP, +0.022 versus +0.027 log10pg/mL; sCD14, -0.016 versus +0.019 log10pg/mL; and D-dimer, -0.031 versus +0.004 log10pg/mL. A history of cancer was associated with higher baseline levels of IL-6 (P=0.002) and CRP (P=0.049). No relationship was observed between baseline biomarker level and persistent residual viraemia, HIV-1 DNA load, plasma lipids and other potential explanatory variables. Conclusions: Simplification with atazanavir/ritonavir plus lamivudine does not affect plasma markers of systemic inflammation in virologically suppressed patients. The association between these findings and clinical outcomes requires further evaluation. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Original languageEnglish
Pages (from-to)1949-1954
Number of pages6
JournalJournal of Antimicrobial Chemotherapy
Volume73
Issue number7
DOIs
Publication statusPublished - 2018

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Ritonavir
Lamivudine
HIV-1
Inflammation
Biomarkers
C-Reactive Protein
Interleukin-6
Therapeutics
Atazanavir Sulfate
Viremia
Random Allocation
Enzyme-Linked Immunosorbent Assay
Lipids
Mortality
DNA

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Systemic inflammation markers after simplification to atazanavir/ritonavir plus lamivudine in virologically suppressed HIV-1-infected patients: ATLAS-M substudy. / Belmonti, S; Lombardi, F; Quiros-Roldan, E; Latini, A; Castagna, A; Borghetti, A; Baldin, G; Ciccullo, A; Cauda, R; De Luca, A; Di Giambenedetto, S; Group, on behalf of the ATLAS-M Study.

In: Journal of Antimicrobial Chemotherapy, Vol. 73, No. 7, 2018, p. 1949-1954.

Research output: Contribution to journalArticle

Belmonti, S, Lombardi, F, Quiros-Roldan, E, Latini, A, Castagna, A, Borghetti, A, Baldin, G, Ciccullo, A, Cauda, R, De Luca, A, Di Giambenedetto, S & Group, OBOTATLAS-MS 2018, 'Systemic inflammation markers after simplification to atazanavir/ritonavir plus lamivudine in virologically suppressed HIV-1-infected patients: ATLAS-M substudy', Journal of Antimicrobial Chemotherapy, vol. 73, no. 7, pp. 1949-1954. https://doi.org/10.1093/jac/dky125
Belmonti, S ; Lombardi, F ; Quiros-Roldan, E ; Latini, A ; Castagna, A ; Borghetti, A ; Baldin, G ; Ciccullo, A ; Cauda, R ; De Luca, A ; Di Giambenedetto, S ; Group, on behalf of the ATLAS-M Study. / Systemic inflammation markers after simplification to atazanavir/ritonavir plus lamivudine in virologically suppressed HIV-1-infected patients: ATLAS-M substudy. In: Journal of Antimicrobial Chemotherapy. 2018 ; Vol. 73, No. 7. pp. 1949-1954.
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abstract = "Background: Biomarkers of systemic inflammation predict non-AIDS events and overall mortality in virologically suppressed HIV-1-infected patients. Objectives: To determine whether switching to a dual antiretroviral maintenance therapy was associated with modification of biomarkers of systemic inflammation as compared with continuation of successful standard triple therapy. Methods: In this substudy of the randomized ATLAS-M trial, we compared in virologically suppressed patients the impact at 1 year of simplification to a dual therapy with atazanavir/ritonavir plus lamivudine versus maintaining atazanavir/ritonavir plus two NRTI triple therapy on markers of systemic inflammation. Plasma levels of interleukin-6, C-reactive protein (CRP), soluble CD14 (sCD14) and D-dimerwere quantified by ELISA at baseline and at 48weeks. Results: A subset of 139 of 266 randomized patients with available samples was analysed: 69 in the triple therapy arm and 70 in the dual therapy arm. The baseline biomarker levels were comparable between randomization arms. No significant differences in changes from baseline to week 48 were observed between arms (dual therapy versus triple therapy): IL-6, -0.030 versus -0.016 log10pg/L; CRP, +0.022 versus +0.027 log10pg/mL; sCD14, -0.016 versus +0.019 log10pg/mL; and D-dimer, -0.031 versus +0.004 log10pg/mL. A history of cancer was associated with higher baseline levels of IL-6 (P=0.002) and CRP (P=0.049). No relationship was observed between baseline biomarker level and persistent residual viraemia, HIV-1 DNA load, plasma lipids and other potential explanatory variables. Conclusions: Simplification with atazanavir/ritonavir plus lamivudine does not affect plasma markers of systemic inflammation in virologically suppressed patients. The association between these findings and clinical outcomes requires further evaluation. {\circledC} The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.",
author = "S Belmonti and F Lombardi and E Quiros-Roldan and A Latini and A Castagna and A Borghetti and G Baldin and A Ciccullo and R Cauda and {De Luca}, A and {Di Giambenedetto}, S and Group, {on behalf of the ATLAS-M Study}",
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T1 - Systemic inflammation markers after simplification to atazanavir/ritonavir plus lamivudine in virologically suppressed HIV-1-infected patients: ATLAS-M substudy

AU - Belmonti, S

AU - Lombardi, F

AU - Quiros-Roldan, E

AU - Latini, A

AU - Castagna, A

AU - Borghetti, A

AU - Baldin, G

AU - Ciccullo, A

AU - Cauda, R

AU - De Luca, A

AU - Di Giambenedetto, S

AU - Group, on behalf of the ATLAS-M Study

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N2 - Background: Biomarkers of systemic inflammation predict non-AIDS events and overall mortality in virologically suppressed HIV-1-infected patients. Objectives: To determine whether switching to a dual antiretroviral maintenance therapy was associated with modification of biomarkers of systemic inflammation as compared with continuation of successful standard triple therapy. Methods: In this substudy of the randomized ATLAS-M trial, we compared in virologically suppressed patients the impact at 1 year of simplification to a dual therapy with atazanavir/ritonavir plus lamivudine versus maintaining atazanavir/ritonavir plus two NRTI triple therapy on markers of systemic inflammation. Plasma levels of interleukin-6, C-reactive protein (CRP), soluble CD14 (sCD14) and D-dimerwere quantified by ELISA at baseline and at 48weeks. Results: A subset of 139 of 266 randomized patients with available samples was analysed: 69 in the triple therapy arm and 70 in the dual therapy arm. The baseline biomarker levels were comparable between randomization arms. No significant differences in changes from baseline to week 48 were observed between arms (dual therapy versus triple therapy): IL-6, -0.030 versus -0.016 log10pg/L; CRP, +0.022 versus +0.027 log10pg/mL; sCD14, -0.016 versus +0.019 log10pg/mL; and D-dimer, -0.031 versus +0.004 log10pg/mL. A history of cancer was associated with higher baseline levels of IL-6 (P=0.002) and CRP (P=0.049). No relationship was observed between baseline biomarker level and persistent residual viraemia, HIV-1 DNA load, plasma lipids and other potential explanatory variables. Conclusions: Simplification with atazanavir/ritonavir plus lamivudine does not affect plasma markers of systemic inflammation in virologically suppressed patients. The association between these findings and clinical outcomes requires further evaluation. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

AB - Background: Biomarkers of systemic inflammation predict non-AIDS events and overall mortality in virologically suppressed HIV-1-infected patients. Objectives: To determine whether switching to a dual antiretroviral maintenance therapy was associated with modification of biomarkers of systemic inflammation as compared with continuation of successful standard triple therapy. Methods: In this substudy of the randomized ATLAS-M trial, we compared in virologically suppressed patients the impact at 1 year of simplification to a dual therapy with atazanavir/ritonavir plus lamivudine versus maintaining atazanavir/ritonavir plus two NRTI triple therapy on markers of systemic inflammation. Plasma levels of interleukin-6, C-reactive protein (CRP), soluble CD14 (sCD14) and D-dimerwere quantified by ELISA at baseline and at 48weeks. Results: A subset of 139 of 266 randomized patients with available samples was analysed: 69 in the triple therapy arm and 70 in the dual therapy arm. The baseline biomarker levels were comparable between randomization arms. No significant differences in changes from baseline to week 48 were observed between arms (dual therapy versus triple therapy): IL-6, -0.030 versus -0.016 log10pg/L; CRP, +0.022 versus +0.027 log10pg/mL; sCD14, -0.016 versus +0.019 log10pg/mL; and D-dimer, -0.031 versus +0.004 log10pg/mL. A history of cancer was associated with higher baseline levels of IL-6 (P=0.002) and CRP (P=0.049). No relationship was observed between baseline biomarker level and persistent residual viraemia, HIV-1 DNA load, plasma lipids and other potential explanatory variables. Conclusions: Simplification with atazanavir/ritonavir plus lamivudine does not affect plasma markers of systemic inflammation in virologically suppressed patients. The association between these findings and clinical outcomes requires further evaluation. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

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DO - 10.1093/jac/dky125

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EP - 1954

JO - Journal of Antimicrobial Chemotherapy

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