Effects of different highly active antiretroviral therapy regimens on immune, biochemical indicators, and viral suppression in HIV/AIDS patients in Southwest China.

Authors

Zongyu Nie, Yan Zheng, Shuanglian Ao, Liuying Yang, Peng Li

Published in

Scientific reports. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

To investigate the effects of different HAART regimens on viral suppression, immune reconstitution, and biochemical indicators in HIV/AIDS patients in Southwest China. This study included 484 patients who received treatment from December 2014 to December 2024. Data on HIV viral load, complete blood count, liver and kidney function, lipid levels, and immunological indicators were collected at baseline and after the final follow-up. Multiple regression models were employed to identify factors influencing viral load, while the Wilcoxon signed-rank test was used to compare changes in indicators from baseline to the final follow-up. Additionally, a multiple regression model was constructed based on univariate linear regression to assess the correlation between immune and biochemical indicators. The INSTI + 2 NRTIs regimen demonstrated a faster rate of viral suppression (Adjusted P < 0.001), with a median time to virological suppression of only 10.44 months, shorter than that of the EFV + 2 NRTIs group (12.36 months) and the LPV/r + 2 NRTIs group (18 months). A numerically larger increase in CD₄⁺ T lymphocyte count was observed in the LPV/r + 2 NRTIs group. However, this was a small subgroup with limited statistical power; therefore, no reliable conclusion that this group is superior to others can be drawn, and the finding should be interpreted with caution. Longitudinal changes in total bilirubin from baseline to the last follow-up were non-significant in the LPV/r + 2 NRTIs group (adjusted P = 0.233). However, intergroup comparisons at the final follow-up revealed significantly higher total bilirubin levels in this regimen compared to the other two groups (adjusted P < 0.001). The EFV + 2 NRTIs regimen significantly reduced CD₈⁺ T lymphocyte counts (Adjusted P < 0.001) and affected changes in ALT and AST levels. Furthermore, after adjusting for confounding factors via multivariable regression analysis, white blood cell counts, platelets, triglycerides, and ALT were positively correlated with CD₄⁺ T lymphocyte counts in the EFV + 2 NRTIs group (adjusted P < 0.01). Notably, triglycerides showed no significant univariate association with CD₄⁺ T lymphocyte counts in this group ; this correlation only became statistically significant after adjustment for confounders in the multivariate model (adjusted P < 0.01). In the INSTI + 2 NRTIs group, multivariable analysis identified positive correlations of both white blood cell counts and hemoglobin with CD₄⁺ T lymphocyte counts (adjusted P < 0.001). In the LPV/r + 2 NRTIs group, multivariate regression revealed that only white blood cell counts were positively correlated with CD₄⁺ T lymphocyte counts (adjusted P < 0.01). The three HAART regimens exhibit differences in their effects on the rate of viral suppression, liver and kidney function, and immune reconstitution. In clinical practice, it is essential to balance efficacy and safety while effectively mitigating associated risks. Additionally, changes in biochemical indicators can be used to assess the recovery of immune indicators.

PMID:
42443280
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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