{"doi":"10.17615/8762-mg89","title":"Impact of first-line antiretroviral therapy regimens on the restoration of the CD4/CD8 ratio in the CNICS cohort","abstract":"Background: The CD4/CD8 ratio is an indicator of immunosenescence and a predictor of all-cause mortality in HIV-infected patients. The effects of different ART regimens on CD4/CD8 ratio recovery remain unclear. Methods: Clinical cohort study of ART-treated patients from the CFAR Network of Integrated Clinical Systems (CNICS). We included ART-naive adults with HIV infection who achieved undetectable HIV RNA during the first 48 weeks of treatment and had additional follow-up 48 weeks after virological suppression (VS). Primary endpoints included increase in CD4/CD8 ratio at both timepoints and secondary endpoints were CD4/CD8 ratio recovery at cut-offs of ≥0.5 or ≥1.0. Results: Of 3971 subjects who met the study criteria, 1876 started ART with an NNRTI, 1804 with a PI and 291 with an integrase strand transfer inhibitor (INSTI). After adjusting for age, sex, race, year of entry, risk group, HCV serostatus, baseline viral load and baseline CD4/CD8 ratio, subjects on an NNRTI showed a significantly greater CD4/CD8 ratio gain compared with those on a PI, either 48 weeks after ART initiation or after 48 weeks of HIV RNA VS. The greater CD4/CD8 ratio improvement in the NNRTI arm was driven by a higher decline in CD8 counts. The INSTI group showed increased rates of CD4/CD8 ratio normalization at the ≥1.0 cut-off compared with the PI group. Conclusions: NNRTI therapy was associated with a greater increase in the CD4/CD8 ratio compared with PIs. NNRTI- and INSTI-based first-line ART were associated with higher rates of CD4/CD8 ratio normalization at a cutoff of 1.0 than a PI-based regimen, which might have clinical implications.","journal":"UNC Libraries","year":2024,"id":499352,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":0.0,"corpus_rank":10103,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5945,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":239685,"name":"Peter W. Hunt","orcid":"0000-0002-4571-4870","position":1,"is_corresponding":false},{"id":551055,"name":"C.J. Achenbach","orcid":null,"position":2,"is_corresponding":false},{"id":429572,"name":"Borja M. Fernández-Félix","orcid":null,"position":3,"is_corresponding":false},{"id":340146,"name":"Sonia Napravnik","orcid":"0000-0002-9032-3713","position":4,"is_corresponding":false},{"id":305156,"name":"Kenneth H. Mayer","orcid":"0000-0001-7460-733X","position":5,"is_corresponding":false},{"id":428870,"name":"Sergio Serrano‐Villar","orcid":"0000-0002-5447-3554","position":6,"is_corresponding":false},{"id":385134,"name":"Sonya L. Heath","orcid":"0000-0002-3826-0954","position":7,"is_corresponding":false},{"id":428867,"name":"Sabina Herrera","orcid":"0000-0002-5057-354X","position":8,"is_corresponding":false},{"id":428433,"name":"Katerina Christopoulos","orcid":"0000-0002-8598-2191","position":9,"is_corresponding":false},{"id":1347854,"name":"CFAR Network of Integrated Clinical Systems","orcid":null,"position":10,"is_corresponding":false},{"id":345852,"name":"Catherine Mathews","orcid":"0000-0001-5368-1127","position":11,"is_corresponding":false},{"id":71691,"name":"Steven G. Deeks","orcid":"0000-0001-6371-747X","position":12,"is_corresponding":false},{"id":428868,"name":"Talía Sainz","orcid":"0000-0002-5301-0945","position":13,"is_corresponding":false},{"id":333576,"name":"Benigno Rodríguez","orcid":"0000-0001-9736-7957","position":14,"is_corresponding":false},{"id":428869,"name":"Santiago Moreno","orcid":"0000-0002-2843-1094","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:09:53.188165Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}