The effect of B/F/TAF compound preparation antiretroviral ther-apy on reconstructing the immune function in patients with HIV

Zhiwei Liu; Zhiwen Chu; Jinping Liang; Youpeng Chen; Xiaorong Zeng; Rikang Ye; Huifeng Chen; Yuncheng Li

Abstract：Objective To compare the effects of two regimens on immune reconstitution in patients with HIV: bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) and efavirenz+tenofovir disoproxil+lamivudine (EFV+TDF+3TC). Methods Using a retrospective research method, basic data, such as age, gender, occupation, HIV infection route, educational level, height, weight, CD4+T cell count, CD8+T cell count, blood glucose, blood lipids, uric acid, and liver and kidney function, were collected from newly diagnosed individuals with HIV. Patients were divided into the B/F/TAF group and the EFV+TDF+3TC group. SPSS software was used to analyze the differences in various indicators and their impact on the recovery of CD4+T lymphocyte levels before and after one-year follow-up. Results There were no statistically significant differences between the two groups in terms of gender, age, liver and kidney function, blood lipids, lymphocyte count, viral load, and other baseline indicators. After one year of treatment, there were statistically significant differences in body mass index (t=1.997, P=0.04), CD4+T lymphocyte count (Z=2.750, P<0.01), low-density lipoprotein (t=2.148, P=0.03), high-density lipoprotein (t=5.546, P<0.01), CD4/CD8 ratio (t=2.217, P=0.02), and serum creatinine (Z=2.026, P=0.04) between the two groups. Meanwhile, there were no statistically significant differences in the CD8+T lymphocyte counts, and the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, fasting blood glucose, total cholesterol, triglycerides, very low-density lipoprotein, serum uric acid, and viral load>200 copies/mL. The B/F/TAF group had fewer drug resistance cases within one year of treatment compared with the EFV+TDF+3TC group. The binary logistic showed that there were statistically significant differences in high-density lipoproteins (OR=4.104, 95%CI(2.035, 8.279)), low-density lipoproteins (OR=1.147, 95%CI(1.028, 1.280)), and CD4+T lymphocyte counts (OR=3.615, 95%CI(1.115, 8.977)). There was a higher proportion of patients with normal CD4+T lymphocyte levels (greater than 500/µL) using the B/F/TAF regimen compared with the EFV+TDF+3TC treatment between 3 months and 1 year after antiretroviral therapy. Conclusion There is a greater recovery of CD4+T lymphocyte count levels in HIV-infected individuals after antiretroviral therapy using the B/F/TAF regimen compared with the EFV+TDF+3TC treatment. At the same time, there is altered lipid metabolism following treatment using the B/F/TAF regimen in patients with HIV.