Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia

Juan C Alzate-Angel; John D Loaiza; Federico Perdomo-Celis; Juan C Hernandez; Ximena Galindo-Orrego; Mónica Mantilla-Suárez; Fanny Guzman; Juan Carlos Cataño; Francisco J Diaz; María T Rugeles; Natalia A Taborda

doi:10.1155/ijm/9081023

Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia

Título traducido de la contribución: Beneficios de los regímenes basados en INSTI en un contexto real de personas con VIH-1 en Colombia

Juan C Alzate-Angel, John D Loaiza, Federico Perdomo-Celis, Juan C Hernandez, Ximena Galindo-Orrego, Mónica Mantilla-Suárez, Fanny Guzman, Juan Carlos Cataño, Francisco J Diaz, María T Rugeles, Natalia A Taborda

Producción: Contribución a una revista › Artículo › revisión exhaustiva

Resumen

Objetivo: El objetivo es comparar las características clínicas, virológicas e inmunológicas de las personas que viven con VIH-1 que fueron tratadas con inhibidores de la integrasa de primera línea (INSTI) versus aquellas tratadas con otros antirretrovirales. Métodos: Este es un estudio descriptivo, observacional, retrospectivo, de dos centros. Seleccionamos individuos que comenzaron la terapia antirretroviral (TAR) dentro del primer año del diagnóstico y que habían recibido al menos 1 año de tratamiento. Su terapia consistió en dos inhibidores de la transcriptasa inversa de nucleósidos/nucleótidos, junto con un tercer medicamento (INSTI, inhibidor de la transcriptasa inversa no nucleósido (NNRTI) o inhibidor de la proteasa). La comparación primaria fue entre individuos que iniciaron TAR que contenía INSTI y aquellos que iniciaron TAR que contenía NNRTI o inhibidores de la proteasa. Evaluamos los resultados clínicos, la carga viral residual, el ADN proviral circulante, la inflamación y los marcadores de riesgo cardiovascular, el recuento y fenotipo de células T, y la frecuencia de células T específicas del VIH. Resultados: Las personas que recibieron regímenes basados en INSTI comenzaron el tratamiento en una etapa más avanzada de la enfermedad y tuvieron una duración de TAR significativamente más corta al momento de la inclusión en el estudio que las personas que no recibieron TAR basada en INSTI. Las personas que recibieron INSTI alcanzaron recuentos de células T CD4 + comparables a los del grupo sin INSTI, así como niveles similares de marcadores virológicos, inmunológicos y cardiovasculares. No obstante, las personas del grupo basado en INSTI presentaron recuentos más altos de células T CD8 + y proporciones CD4/CD8+ más bajas, así como niveles más bajos de lipoproteínas de alta densidad. Conclusiones: Los regímenes basados en INSTI ofrecen beneficios a las personas colombianas que viven con VIH-1 y que inician TAR, incluyendo una reconstitución virológica y de células T CD4 + mejorada y más rápida . Esto ocurre a pesar del inicio del tratamiento para la enfermedad avanzada.

Título traducido de la contribución	Beneficios de los regímenes basados en INSTI en un contexto real de personas con VIH-1 en Colombia
Idioma original	Inglés
Número de artículo	9081023
Páginas (desde-hasta)	1-10
Número de páginas	10
Publicación	International Journal of Microbiology
Volumen	2025
N.º	1
DOI	https://doi.org/10.1155/ijm/9081023
Estado	Publicada - 11 sep. 2025

Palabras clave

terapia antirretroviral de primera línea
inhibidores de la transferencia de la cadena de la integrasa
inhibidores de la transcriptasa inversa análogos de nucleósidos
inhibidores de la proteasa
supresión viral

ODS de las Naciones Unidas

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10.1155/ijm/9081023

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Alzate-Angel, J. C., Loaiza, J. D., Perdomo-Celis, F., Hernandez, J. C., Galindo-Orrego, X., Mantilla-Suárez, M., Guzman, F., Cataño, J. C., Diaz, F. J., Rugeles, M. T., & Taborda, N. A. (2025). Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia. International Journal of Microbiology, 2025(1), 1-10. Artículo 9081023. https://doi.org/10.1155/ijm/9081023

@article{336272d20bfa405288d1f4d0f07a104a,

title = "Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia",

abstract = " Objective: The objective is to compare the clinical, virological, and immunological characteristics of people living with HIV-1 who were treated with first-line integrase inhibitors (INSTIs) versus those treated with other antiretrovirals. Methods: This is a descriptive observational, retrospective, two-center study. We selected individuals who began antiretroviral therapy (ART) within the first year of diagnosis and who had received at least 1 year of treatment. Their therapy consisted of two nucleoside/nucleotide reverse transcriptase inhibitors, along with a third medication (INSTI, nonnucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor). The primary comparison was between individuals who initiated ART containing INSTIs and those who initiated ART containing NNRTIs or protease inhibitors. We evaluated clinical outcomes, residual viral load, circulating proviral DNA, inflammation, and cardiovascular risk markers, T cell count and phenotype, and the frequency of HIV-specific T cells. Results: Individuals who received INSTI-based regimens started treatment at a more advanced disease stage and had a significantly shorter ART duration at study inclusion than individuals who did not receive INSTI-based ART. Individuals receiving INSTIs achieved CD4 + T cell counts at levels comparable to those within the non-INSTI group, as well as similar levels of virological, immunological, and cardiovascular markers. Nonetheless, those in the INSTI-based group had higher CD8 + T cell counts and lower CD4/CD8 ratios, as well as lower high-density lipoprotein levels. Conclusions: INSTI-based regimens offer benefits to Colombian people living with HIV-1, who are starting ART, including improved and faster virological and CD4 + T cell reconstitution. This occurs despite treatment initiation for advanced disease. ",

keywords = "first-line antiretroviral therapy, integrase strand transfer inhibitors, nucleoside (tide) reverse transcriptase inhibitors, protease inhibitors, viral suppression, terapia antirretroviral de primera l{\'i}nea, inhibidores de la transferencia de la cadena de la integrasa, inhibidores de la transcriptasa inversa an{\'a}logos de nucle{\'o}sidos, inhibidores de la proteasa, supresi{\'o}n viral",

author = "Alzate-Angel, \{Juan C\} and Loaiza, \{John D\} and Federico Perdomo-Celis and Hernandez, \{Juan C\} and Ximena Galindo-Orrego and M{\'o}nica Mantilla-Su{\'a}rez and Fanny Guzman and Cata{\~n}o, \{Juan Carlos\} and Diaz, \{Francisco J\} and Rugeles, \{Mar{\'i}a T\} and Taborda, \{Natalia A\}",

note = "Copyright {\textcopyright} 2025 Juan C. Alzate-Angel et al. International Journal of Microbiology published by John Wiley \& Sons Ltd.",

year = "2025",

month = sep,

day = "11",

doi = "10.1155/ijm/9081023",

language = "English",

volume = "2025",

pages = "1--10",

journal = "International Journal of Microbiology",

issn = "1687-918X",

publisher = "John Wiley and Sons Ltd",

number = "1",

}

Alzate-Angel, JC, Loaiza, JD, Perdomo-Celis, F, Hernandez, JC, Galindo-Orrego, X, Mantilla-Suárez, M, Guzman, F, Cataño, JC, Diaz, FJ, Rugeles, MT & Taborda, NA 2025, 'Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia', International Journal of Microbiology, vol. 2025, n.º 1, 9081023, pp. 1-10. https://doi.org/10.1155/ijm/9081023

TY - JOUR

T1 - Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia

AU - Alzate-Angel, Juan C

AU - Loaiza, John D

AU - Perdomo-Celis, Federico

AU - Hernandez, Juan C

AU - Galindo-Orrego, Ximena

AU - Mantilla-Suárez, Mónica

AU - Guzman, Fanny

AU - Cataño, Juan Carlos

AU - Diaz, Francisco J

AU - Rugeles, María T

AU - Taborda, Natalia A

PY - 2025/9/11

Y1 - 2025/9/11

N2 - Objective: The objective is to compare the clinical, virological, and immunological characteristics of people living with HIV-1 who were treated with first-line integrase inhibitors (INSTIs) versus those treated with other antiretrovirals. Methods: This is a descriptive observational, retrospective, two-center study. We selected individuals who began antiretroviral therapy (ART) within the first year of diagnosis and who had received at least 1 year of treatment. Their therapy consisted of two nucleoside/nucleotide reverse transcriptase inhibitors, along with a third medication (INSTI, nonnucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor). The primary comparison was between individuals who initiated ART containing INSTIs and those who initiated ART containing NNRTIs or protease inhibitors. We evaluated clinical outcomes, residual viral load, circulating proviral DNA, inflammation, and cardiovascular risk markers, T cell count and phenotype, and the frequency of HIV-specific T cells. Results: Individuals who received INSTI-based regimens started treatment at a more advanced disease stage and had a significantly shorter ART duration at study inclusion than individuals who did not receive INSTI-based ART. Individuals receiving INSTIs achieved CD4 + T cell counts at levels comparable to those within the non-INSTI group, as well as similar levels of virological, immunological, and cardiovascular markers. Nonetheless, those in the INSTI-based group had higher CD8 + T cell counts and lower CD4/CD8 ratios, as well as lower high-density lipoprotein levels. Conclusions: INSTI-based regimens offer benefits to Colombian people living with HIV-1, who are starting ART, including improved and faster virological and CD4 + T cell reconstitution. This occurs despite treatment initiation for advanced disease.

AB - Objective: The objective is to compare the clinical, virological, and immunological characteristics of people living with HIV-1 who were treated with first-line integrase inhibitors (INSTIs) versus those treated with other antiretrovirals. Methods: This is a descriptive observational, retrospective, two-center study. We selected individuals who began antiretroviral therapy (ART) within the first year of diagnosis and who had received at least 1 year of treatment. Their therapy consisted of two nucleoside/nucleotide reverse transcriptase inhibitors, along with a third medication (INSTI, nonnucleoside reverse transcriptase inhibitor (NNRTI), or protease inhibitor). The primary comparison was between individuals who initiated ART containing INSTIs and those who initiated ART containing NNRTIs or protease inhibitors. We evaluated clinical outcomes, residual viral load, circulating proviral DNA, inflammation, and cardiovascular risk markers, T cell count and phenotype, and the frequency of HIV-specific T cells. Results: Individuals who received INSTI-based regimens started treatment at a more advanced disease stage and had a significantly shorter ART duration at study inclusion than individuals who did not receive INSTI-based ART. Individuals receiving INSTIs achieved CD4 + T cell counts at levels comparable to those within the non-INSTI group, as well as similar levels of virological, immunological, and cardiovascular markers. Nonetheless, those in the INSTI-based group had higher CD8 + T cell counts and lower CD4/CD8 ratios, as well as lower high-density lipoprotein levels. Conclusions: INSTI-based regimens offer benefits to Colombian people living with HIV-1, who are starting ART, including improved and faster virological and CD4 + T cell reconstitution. This occurs despite treatment initiation for advanced disease.

KW - first-line antiretroviral therapy

KW - integrase strand transfer inhibitors

KW - nucleoside (tide) reverse transcriptase inhibitors

KW - protease inhibitors

KW - viral suppression

KW - terapia antirretroviral de primera línea

KW - inhibidores de la transferencia de la cadena de la integrasa

KW - inhibidores de la transcriptasa inversa análogos de nucleósidos

KW - inhibidores de la proteasa

KW - supresión viral

U2 - 10.1155/ijm/9081023

DO - 10.1155/ijm/9081023

M3 - Article

C2 - 40969513

SN - 1687-918X

VL - 2025

SP - 1

EP - 10

JO - International Journal of Microbiology

JF - International Journal of Microbiology

IS - 1

M1 - 9081023

ER -

Benefits of INSTI-Based Regimens in a Real-World Setting ofPeople Living With HIV-1 in Colombia

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ODS de las Naciones Unidas

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