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Title: Immunological function restoration with Lopinavir/ritonavir vs Efavirenz containing regimens in HIV infected patients: a randomized clinical trial
Author: Torres, Berta
Rallón, Norma
Loncá, Montserrat
Díaz Lorca, Maria Alba
Alós i Hernández, Llúcia
Martínez Chamorro, Esteban José
Cruceta, Anna
Arnaiz Gargallo, Juan Alberto
Leal, Lorna
Lucero, Constanza
León García, Agathe
Sánchez, Marcelo
Negredo, Eugènia
Clotet, Bonaventura, 1953-
Gatell, José M.
Benito, José M.
García Alcaide, Felipe
Keywords: VIH (Virus)
Sistema immunològic
HIV (Viruses)
Immune system
Antiretroviral agents
Issue Date: 2-May-2014
Publisher: Mary Ann Liebert
Abstract: CD4+ count increase has been reported to be different with lopinavir/r (LPV/r) and efavirenz (EFV)-containing regimens. The different effect of these two regimens on other immune function parameters and the relationship with the gain of CD4+ count have not been assessed in a randomized clinical trial. Fifty antiretroviral treatment (cART) naïve HIV-infected individuals were randomized to receive LPV/r or EFV both with tenofovir/emtricitabine for 48 weeks. A substudy of immunological function restoration was performed in 22 patients (LPV/r n=10 and EFV n=12). Activation, thymic function, apoptosis, senescence, exhaustion, Treg cells, interleukin (IL)-7-receptor/IL-7 system, thymic volume, and lymphoid tissue fibrosis were evaluated at baseline and at week 48. Both groups experienced a CD4+ count increase that was higher in the EFV group (ΔCD4+ 88 vs. 315 cells/μl LPV/r vs. EFV, respectively, p<0.001). Despite this difference in CD4+ gain, the change in other immune function parameters was similar in both treatment groups. Most of parameters evaluated tended to normalize after 48 weeks of cART. A significant decrease in levels of activation, senescence, exhaustion, and apoptosis on CD4+ and CD8+ T cells (p<0.001 for all) and a significant increase in markers of thymic function, IL-7 receptor, and in the levels of central memory CD4+ T cells and naive subsets of CD8+ T cells (p<0.001 for all) with respect to baseline values were observed without any difference between groups. These data indicate that the differences in CD4+ gain with different cART regimens are not immunologically meaningful and might explain the similar clinical efficacy of these regimens.
Note: Reproducció del document publicat a:
It is part of: Aids Research and Human Retroviruses, 2014, vol. 30, num. 5, p. 425-433
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ISSN: 0889-2229
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (Fonaments Clínics)

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