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Immunological recovery with BIC/FTC/TAF: CD4 T-cell count and CD4/CD8 ratio as markers of response
Valeria Bono1, Giulia C Marchetti1
1Clinic of Infectious Diseases, Dept. of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan.
Insights
The CD4/CD8 ratio indicates immune health in advanced HIV. Bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) effectively restores immune function and reduces inflammation in these patients.
Area of Science:
- Immunology
- Virology
- Pharmacology
Background:
- The CD4/CD8 ratio is a key indicator of immune dysregulation, senescence, and inflammation, impacting non-AIDS conditions and mortality.
- Late HIV diagnosis with advanced immune suppression (CD4 <350 cells/μL) remains prevalent, particularly in Italy.
- Restoring immune function is critical for managing advanced HIV.
Purpose of the Study:
- To evaluate the efficacy of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) in immune recovery for patients with advanced HIV.
- To assess the impact of BIC/FTC/TAF on virological suppression and inflammatory markers.
Main Methods:
- Comparative analysis of treatment outcomes in advanced HIV patients.
- Assessment of CD4 counts, HIV RNA levels, and inflammatory markers.
Main Results:
- BIC/FTC/TAF demonstrated superior efficacy in restoring immune function, particularly CD4 counts.
- High rates of virological suppression and durable immune reconstitution were observed.
- Favorable safety profile and reduction in inflammatory markers, potentially benefiting cardiovascular health.
Conclusions:
- BIC/FTC/TAF is a highly effective treatment option for advanced HIV.
- The regimen contributes to significant immune recovery and reduced systemic inflammation.
- BIC/FTC/TAF offers a promising strategy for improving long-term outcomes in advanced HIV patients.
Abstract:
The CD4/CD8 ratio is a crucial marker of immune dysregulation, immune senescence, and inflammation, predicting outcomes such as non-AIDS conditions and mortality. A low CD4/CD8 ratio is common in late HIV diagnoses, which remain frequent in Italy, where 58% of new cases occur with advanced immune suppression (CD4 <350 cells/μL). Recent advancements in cART, particularly bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), have demonstrated superior efficacy in restoring immune function, especially in late-stage HIV. BIC/FTC/TAF offers high virological suppression, durable immune reconstitution, and a favorable safety profile. Comparative studies highlight its advantages in improving CD4 counts, reducing HIV RNA, and mitigating inflammatory markers, suggesting potential cardiovascular benefits. These findings position BIC/FTC/TAF as an effective option for advanced HIV treatment, contributing to better immune recovery and reduced systemic inflammation.
