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No evidence of autoimmune disorders in antiretroviral-experienced HIV-1-infected subjects after long-term treatment with raltegravir.
MedLine Citation:
PMID:  23047152     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The HIV integrase inhibitor raltegravir (RAL) can exacerbate autoimmune diseases in genetically predisposed mice. To evaluate whether this may occur in clinical practice, we clinically monitored HIV positive patients treated with RAL and measured a panel of autoantibodies (auto-Abs) during the first year of RAL treatment. METHODS: This was a longitudinal study in 109 antiretroviral-experienced patients who started a RAL-based regimen and were followed up for more than two years. Forty-five of them were tested at baseline (before starting RAL) and after 12 months for the presence of the following auto-Abs: anti-nuclear antibodies (ANA), anti-double-stranded (ds)DNA, anti-smooth-muscle antibodies (ASMA), anti-thyreoglobulin (anti-TG) and anti-thyroid peroxidase (anti-TPO) antibodies, anti-cardiolipin (anti-CL) IgG and IgM, anti-nuclear extractable antigens (ENA) including anti-SM RNP antigen, anti-Ro (SSA) antigen and anti-La (SSB) antigen. RESULTS: A low rate of clinically relevant autoimmune diseases was observed at study entry (3/109, 2.8%, 95%CI = 0.004 - 0.059). No exacerbations were observed during follow-up. During the second year of RAL-based therapy a previously healthy patient developed psoriasis. At baseline 17/45 (37.8%) patients tested for the presence of auto-Abs were positive. Most subjects (13) were positive for anti-CL. After 12 months of RAL exposure 9/45 subjects were positive (20%, p = 0063). A positive correlation was found between HIV-1 RNA and anti-CL antibody concentration (p = 0.010). CONCLUSIONS: According to these results, RAL does not promote antibody-mediated immune disorders at least in the mid-term. A prolonged follow up and an extension of autoAbs' panel are recommended to support these results.
Authors:
Silvia Baroncelli; Ivano Mezzaroma; Alessandra Fantauzzi; Maria Clementina Galluzzo; Anna Degli Antoni; Vincenzo Vullo; Daniela Francisci; Nicoletta Ladisa; Angela Vivarelli; Oscar Cirioni; Laura Sighinolfi; Liliana Elena Weimer; Vincenzo Fragola; Rina Fidanza; Andrea Cara; Lucia Palmisano
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-09
Journal Detail:
Title:  Antiviral therapy     Volume:  -     ISSN:  2040-2058     ISO Abbreviation:  Antivir. Ther. (Lond.)     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815705     Medline TA:  Antivir Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Istituto Superiore di Sanità, Rome, Italy.
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