{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T20:26:57Z","timestamp":1748550417350,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Persistent inflammation and immune activation are associated with lymph node fibrosis and end\u2010organ diseases in treatment\u2010suppressed people living with HIV (PLWH). We investigated the effect of switching to raltegravir and\/or adding losartan on lymphoid tissue fibrosis and on the inflammatory\/immune\u2010activation mediators in treated HIV patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Chronic HIV\u2010infected patients treated with two nucleoside reverse transcriptase inhibitors (2NRTI) and one non\u2010NRTI (NNRTI) or protease inhibitor (PI) during at least 48\u00a0weeks were randomized to four groups (<jats:italic>n<\/jats:italic>\u00a0=\u00a048): 2NRTI\u00a0+\u00a0efavirenz (EFV), 2NRTI\u00a0+\u00a0EFV\u00a0+\u00a0losartan, 2NRTI\u00a0+\u00a0raltegravir and 2NRTI\u00a0+\u00a0raltegravir\u00a0+\u00a0losartan for 48\u00a0weeks. Tonsillar biopsy and peripheral blood markers of CD4 and CD8\u00a0T\u2010lymphocyte activation and senescence, monocyte activation and soluble markers of inflammation were determined at baseline and at week 48 and compared between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No changes in lymphoid tissue architecture were observed. Adding losartan had no impact on lymphocyte subsets. Conversely, patients who switched to raltegravir showed a higher decrease in all activated [CD4+CD38+HLA\u2010DR+, \u22120.3 <jats:italic>vs<\/jats:italic>. 0.48 (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.033); CD8+CD38+\u00a0HLA\u2010DR+, \u22121.6 <jats:italic>vs<\/jats:italic>. 1.3 (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.02)] and senescent [CD4+CD28\u2013CD57+, \u22120.3 <jats:italic>vs<\/jats:italic>. 0.26 (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.04); CD8+CD28\u2013CD57+, \u22126.1 <jats:italic>vs<\/jats:italic>. 3.8 (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.002)] T lymphocytes. In addition, the median CD4\/CD8 ratio increased by 0.35 in patients in the raltegravir group <jats:italic>vs<\/jats:italic>. 0.03 in the other arms (<jats:italic>P\u00a0<\/jats:italic>=\u00a00.002). Differences between groups in monocyte subpopulations or soluble inflammation markers were not observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Losartan had no effect on lymphoid fibrosis or immune activation\/inflammation. Conversely, switching to a regimen with <jats:bold>r<\/jats:bold>altegravir significantly decreased activated and senescent T\u2010lymphocyte subpopulations and increased CD4\/CD8 ratio in successfully treated PLWH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13114","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T01:59:51Z","timestamp":1626832791000},"page":"674-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of switching to raltegravir and\/or adding losartan in lymphoid tissue fibrosis and inflammation in people living with HIV. A randomized clinical trial"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1996-4726","authenticated-orcid":false,"given":"B","family":"Torres","sequence":"first","affiliation":[{"name":"Infectious Diseases Department Hospital Cl\u00ednic Barcelona Spain"},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AC","family":"Guardo","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Squarcia","sequence":"additional","affiliation":[{"name":"Radiology Department Hospital Cl\u00ednic Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Diaz","sequence":"additional","affiliation":[{"name":"Pathology Department Hospital Cl\u00ednic Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Fabra","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Caballero","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS) Barcelona Spain"},{"name":"Otorhinolaryngology Department Hospital Cl\u00ednic Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Cl\u00ednic Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Leal","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Cl\u00ednic Barcelona Spain"},{"name":"Institut d\u2019Investigacions 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