{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:02Z","timestamp":1787014322833,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"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":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our objective was to compare the immunological responses to commonly used antiretroviral therapy (ART) regimens among people with advanced HIV in the USA and to assess virological outcomes and regimen persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included ART\u2010na\u00efve adults with advanced HIV infection (CD4 cell count &lt;200 cells\/\u03bcL) initiating ART with bictegravir\/emtricitabine\/tenofovir alafenamide (B\/F\/TAF), boosted darunavir (bDRV), dolutegravir (DTG), or elvitegravir (EVG\/c)\u2010containing regimens between 1 January 2018 and 31 December 2020 in the Observational Pharmaco\u2010Epidemiology Research and Analysis (OPERA) cohort. Cox proportional hazards models and linear mixed models with random intercept were fit with inverse probability of treatment weighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 1349 people with advanced HIV (816 B\/F\/TAF, 253 DTG, 146 EVG\/c, 134 bDRV) were followed for a median of 22\u2009months. Compared with B\/F\/TAF, a lower likelihood of achieving a CD4 cell count \u2265200 cells\/\u03bcL was observed with bDRV (hazard ratio [HR] 0.76; 95% confidence interval [CI] 0.60\u20130.96), DTG (HR 0.82; 95% CI 0.69\u20130.98), and EVG\/c (HR 0.73; 95% CI 0.57\u20130.93). All groups had a similar pattern of CD4:CD8 ratio changes: a rapid increase in the first 6\u00a0months (ranging from +0.15 to +0.16\u2009units), followed by a slower increase thereafter. Only 40 individuals (4%) achieved CD4:CD8 ratio normalization (\u22651). B\/F\/TAF was associated with a faster time to virological suppression (viral load &lt;200 copies\/mL) and a slower time to discontinuation compared with other regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among people with advanced HIV infection, B\/F\/TAF initiation was associated with faster CD4 cell count recovery and favourable virological outcomes compared with bDRV\u2010, DTG\u2010, and EVG\/c\u2010based regimens, although no difference was observed in CD4:CD8 ratio changes over time across regimens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13467","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T22:24:36Z","timestamp":1676499876000},"page":"716-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Immune response to\n                    <scp>ART<\/scp>\n                    initiation in advanced\n                    <scp>HIV<\/scp>\n                    infection"],"prefix":"10.1111","volume":"24","author":[{"given":"Karam","family":"Mounzer","sequence":"first","affiliation":[{"name":"Philadelphia FIGHT  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8467-4835","authenticated-orcid":false,"given":"Laurence","family":"Brunet","sequence":"additional","affiliation":[{"name":"Epividian  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1556-811X","authenticated-orcid":false,"given":"Jennifer S.","family":"Fusco","sequence":"additional","affiliation":[{"name":"Epividian  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian R.","family":"McNicholl","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  Foster City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Dunbar","sequence":"additional","affiliation":[{"name":"Gilead Sciences, Inc.  Foster City California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sension","sequence":"additional","affiliation":[{"name":"CAN Community Health  Ft. Lauderdale Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis H.","family":"McCurdy","sequence":"additional","affiliation":[{"name":"Atrium Health  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Fusco","sequence":"additional","affiliation":[{"name":"Epividian  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2010.00857.x"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix915"},{"issue":"2","key":"e_1_2_11_4_1","first-page":"2017","article-title":"Monitoring selected national HIV prevention and care objectives by using HIV surveillance data\u2014United States and 6 dependent areas, 2015","volume":"22","author":"Centers for Disease Control and Prevention","year":"2017","journal-title":"HIV Surveill Suppl Rep"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12962"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac361"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000286597.57066.2b"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn169"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(19)30189-4"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10040716"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2019.05.005"},{"key":"e_1_2_11_12_1","article-title":"The direct medical costs of late presentation (<350\/mm3) of HIV infection over a 15\u2010year period","volume":"2012","author":"Krentz HB","year":"2012","journal-title":"AIDS Res Treat"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181f81c4a"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2004.00193.x"},{"key":"e_1_2_11_15_1","unstructured":"Panel on antiretroviral guidelines for adults and adolescents and Department of Health and Human Services. 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