Tenofovir-Based Highly Active Antiretroviral Therapy Is Associated with Superior CD4 T Cells Repopulation Compared to Zidovudine-Based HAART in HIV 1 Infected Adults

Abstract

Tenofovir-based highly active antiretroviral therapy (HAART) is one of the preferred first-line therapies in the management of HIV 1 infection. Ghana has since 2014 adopted this recommendation; however there is paucity of scientific data that reflects the safety and efficacy of the tenofovir-based therapy compared to zidovudine in the Ghanaian health system. This study sought to assess the comparative immune reconstitution potential between tenofovir and zidovudine-based HAART regimens, which includes lamivudine and efavirenz in combination therapy. It also aimed to investigate the adverse drug reactions/events (ADREs) associated with pharmacotherapy with these agents in a total of 106 HAART naïve HIV patients. The study included 80 patients in the tenofovir cohort while 26 patients were on the zidovudine regimen. The occurrence of HIV comorbidities profile was assessed at diagnosis and throughout the study period. The baseline CD4 T cells count of the participants was also assessed at diagnosis and repeated at a median period of five months (range 4–6 months), after commencing treatment with either tenofovir- or zidovudine-based HAART. After five months of the HAART, the tenofovir cohort recorded higher CD4 T cell count change from baseline compared to the zidovudine cohort (p < 0.0001). The patients on the tenofovir-based HAART and female sex however appeared to be associated with more multiple ADREs.

Renal function is preserved following Tenofovir Disoproxil Fumarate (TDF) initiation among Rwandan’s living with HIV

“…We detected a statistically significant, but clinically small, improvement in mean renal function after 6 months of TDF use among 476 ART-naïve patients initiating TDF-based first line ART after July 1, 2016. While some studies outside of Africa have found renal toxicity in PLWH on TDF(1)(3)(4), our findings are in agreement with most of the studies from Africa and outside of Africa that have reported TDF to be associated with good clinical outcomes and found to have few side effects in healthy patients(9)(13)(14)(15)(16)…”

Nutritional status and other predictors of immune response recovery among HIV-AIDS patients receiving antiretroviral therapy in Dr. Sardjito Hospital, Yogyakarta, Indonesia: a retrospective cohort study

“…A retrospective cohort study conducted by Ayele, Jarso & Mamo (2017) for two years in Ethiopia showed that the TDF regimen had better immune improvements. A prospective study conducted by Badii & Buabeng (2018) in Ghana also showed that patients taking TDF ARVs had a higher CD4 cell increase compared to those using ZDV.…”

Clinicopathological Features and Mortality in Patients With Kaposi Sarcoma and HIV: A Retrospective Analysis of a Thirty-Year Study From a Peruvian Oncologic Center

“…HAART has been associated with a higher CD4 T cells recovery rate compared with non–HAART-based antiretroviral therapy with zidovudine through reduced chronic immune activation, cytolysis, cytotoxic viral proteins, and an increase in thymic function. 14 - 17 Previous reports have suggested that protease inhibitors contained in HAART regimens may be effective in controlling KS independently of immune reconstitution. Protease inhibitors have shown pleiotropic effects having a direct effect on angiogenesis and tumor growth and on human herpesvirus type 8 replication, by targeting the proteasomes and matrix metalloproteinases MMPS and blocking the production of cytokines.…”