No evidence of autoimmune disorders in antiretroviral-experienced HIV-1-infected individuals after long-term treatment with raltegravir.

Abstract

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 2 years. A total of 45 patients were tested at baseline (before starting RAL) and after 12 months for the presence of the following auto-Abs: anti-nuclear antibodies, anti-double-stranded DNA, anti-smooth-muscle antibodies, anti-thyreoglobulin and anti-thyroid peroxidase antibodies, anti-cardiolipin immunoglobulin G and immunoglobulin M and anti-nuclear extractable antigens, including anti-SM ribonucleoprotein antigen, anti-Ro antigen and anti-La 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 patients (n=13) were positive for anti-cardiolipin. After 12 months of RAL exposure, 9/45 patients were positive (20%; P=0.063). A positive correlation was found between HIV-1 RNA and anti-cardiolipin antibody concentration (P=0.010).

CONCLUSIONS:

According to these results, RAL does not promote antibody-mediated immune disorders, at least not in the mid-term. A prolonged follow-up and an extension of the panel of auto-Abs are recommended to support these results.

• Authors: Silvia Baroncelli, Ivano Mezzaroma, Alessandra Fantauzzi, Clementina M Galluzzo, Anna Degli Antoni, Vincenzo Vullo, Daniela Francisci, Nicoletta Ladisa, Angela Vivarelli, Oscar Cirioni, Laura Sighinolfi, Liliana E Weimer, Vincenzo Fragola, Rina Fidanza, Andrea Cara, Lucia Palmisano
• Journal: Antiviral therapy (Antivir Ther) Vol. 18 Issue 3 Pg. 321-7 ( 2013) ISSN: 2040-2058 [Electronic] England
• PMID: 23047152 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Autoantibodies
• HIV Integrase Inhibitors
• Pyrrolidinones
• Receptors, IgE
• Raltegravir Potassium

Topics

• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood, immunology)
• Autoimmune Diseases (complications)
• CD4 Lymphocyte Count
• Female
• Follow-Up Studies
• HIV Infections (complications, drug therapy, immunology)
• HIV Integrase Inhibitors (adverse effects, therapeutic use)
• HIV-1
• Humans
• Male
• Middle Aged
• Pyrrolidinones (adverse effects, therapeutic use)
• Raltegravir Potassium
• Receptors, IgE (blood, immunology)
• Retrospective Studies
• Viral Load