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Blood Telomere Length Changes after Ritonavir-Boosted Darunavir Combined with Raltegravir or Tenofovir-Emtricitabine in Antiretroviral-Naive Adults Infected with HIV-1

Journal article
Authors N. Stella-Ascariz
R. Montejano
J. Rodriguez-Centeno
B. Alejos
C. Schwimmer
J. I. Bernardino
B. Rodes
C. Allavena
C. Hoffmann
Magnus Gisslén
R. De Miguel
A. Esteban-Cantos
C. Wallet
F. Raffi
J. R. Arribas
Published in Journal of Infectious Diseases
Volume 218
Issue 10
Pages 1523-1530
ISSN 0022-1899
Publication year 2018
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 1523-1530
Language en
Links dx.doi.org/10.1093/infdis/jiy399
Subject categories Infectious Medicine

Abstract

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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