{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:05:21Z","timestamp":1789182321556,"version":"build-2803163510"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dual antiretroviral therapy (ART) with dolutegravir\/lamivudine (DTG\/3TC) is widely used in virologically suppressed individuals. However, data remain limited on potential differential effects of ART regimens on mid-term systemic inflammation and metabolic health. We evaluated whether switching from DTG\/3TC to bictegravir\/emtricitabine\/tenofovir alafenamide (BIC\/FTC\/TAF) modifies systemic inflammation or metabolic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>INSTINCT was a phase IV, multicenter, open-label, randomized trial enrolling adults with HIV-1 on stable DTG\/3TC and sustained viral suppression. Participants were randomized (1:1) to continue DTG\/3TC or switch to BIC\/FTC\/TAF and followed for 96 weeks. Plasma biomarkers (sCD14, IL-6, sCD163, hsCRP, D-dimer, and kynurenine\/tryptophan ratio) were measured at baseline, week 48, and week 96. Secondary outcomes included CD4\u207a and CD4\/CD8 ratio, virological suppression, weight, lipid profile, and renal function. Longitudinal changes were analyzed using linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 141 participants were randomized. Over 96 weeks, no significant between-group differences were observed in inflammatory biomarkers. CD4\u207a T-cell counts and CD4\/CD8 ratio remained stable and comparable across arms. Weight changes were modest and similar; the proportion with \u22655% weight gain did not differ. No relevant differences were found in lipids, glucose, or eGFR. Virological suppression was maintained in &amp;gt;95% of participants. Adverse events were mild and balanced between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In virologically suppressed individuals, maintaining DTG\/3TC or switching to BIC\/FTC\/TAF demonstrated equivalent profiles with respect to systemic inflammation, metabolic outcomes, and immunologic markers over 96 weeks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf565","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:12:57Z","timestamp":1760011977000},"page":"e262-e274","source":"Crossref","is-referenced-by-count":6,"title":["Comparable Inflammatory and Metabolic Outcomes After Switching to Bictegravir\/Emtricitabine\/Tenofovir Alafenamide Versus Continuing Dolutegravir\/Lamivudine in Virologically Suppressed Adults With HIV (INSTINCT\/GESIDA10918 Study)"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5447-3554","authenticated-orcid":false,"given":"Sergio","family":"Serrano-Villar","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Hospital Ram\u00f3n y Cajal, IRYCIS, and Universidad de Alcal\u00e1 , Madrid ,","place":["Spain"]},{"name":"CIBER de Enfermedades Infecciosas , Madrid ,","place":["Spain"]},{"name":"Department of Medicine , Universidad Antonio de Nebrija, Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mart\u00edn-Pedraza","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Ram\u00f3n y Cajal, IRYCIS, and Universidad de Alcal\u00e1 , Madrid ,","place":["Spain"]},{"name":"CIBER de Enfermedades Infecciosas , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0073-873X","authenticated-orcid":false,"given":"Juan","family":"Tiraboschi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Universitario de Bellvitge , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Novella","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Pr\u00edncipe de Asturias , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8429-8358","authenticated-orcid":false,"given":"Alfonso","family":"Cabello-\u00dabeda","sequence":"additional","affiliation":[{"name":"(IIS-FJD, UAM) Division of Infectious Diseases, Health Research Institute-Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital and Universidad Aut\u00f3noma de Madrid , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3804-3458","authenticated-orcid":false,"given":"Luis","family":"L\u00f3pez-Cort\u00e9s","sequence":"additional","affiliation":[{"name":"Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen del Roc\u00edo , Sevilla ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5251-2161","authenticated-orcid":false,"given":"Carmen","family":"Busca","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Infecciosas , Madrid ,","place":["Spain"]},{"name":"Department of Internal Medicine, Hospital Universitario La Paz and CIBERINFEC , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-7405","authenticated-orcid":false,"given":"Miguel","family":"Torralba","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario de Guadalajara , Guadalajara ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Crusells","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Cl\u00ednico Universitario Lozano Blesa , Zaragoza ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-5728","authenticated-orcid":false,"given":"Carmen","family":"Hidalgo-Tenorio","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital Universitario Virgen de las Nieves , Instituto de Investigaci\u00f3n Biosanitario de Granada (IBS-Granada), Granada ,","place":["Spain"]},{"name":"Instituto de Investigaci\u00f3n Biosanitario de Granada (IBS) Granada ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicente","family":"Estrada","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Infecciosas , Madrid ,","place":["Spain"]},{"name":"Department of Internal Medicine, Hospital Universitario Cl\u00ednico San Carlos, IdiSSC and Universidad Complutense Madrid, Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0262-1409","authenticated-orcid":false,"given":"Ana","family":"del Amo-de Palacios","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Ram\u00f3n y Cajal, IRYCIS, and Universidad de Alcal\u00e1 , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"D\u00edaz de Santiago","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Puerta de Hierro , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Fons-Contreras","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Ram\u00f3n y Cajal, IRYCIS, and Universidad de Alcal\u00e1 , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Santos","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital Universitario Virgen de la Victoria de M\u00e1laga. IBIMA-Platafoma BIONAND M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4041-0579","authenticated-orcid":false,"given":"Enrique","family":"Bernal","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital Universitario Reina Sof\u00eda de Murcia , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Montero-Alonso","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Hospital Universitario y Polit\u00e9cnico La F\u00e9 , Valencia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7323-114X","authenticated-orcid":false,"given":"Jes\u00fas","family":"Troya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hospital Universitario Infanta Leonor , Madrid 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