Effect on CD4 T-cell count of replacing protease inhibitors in patients with successful HIV suppression: a meta-analysis.

Abstract

Protease inhibitor (PI) therapy may be associated with adverse events. Switching the PI component to a non-PI may reduce some side-effects, but the immune effects are unclear. In a meta-analysis using strict inclusion criteria, a randomized switch from PI was associated with impaired CD4 T-cell gains compared with maintaining PI (PI arm +32 cells, effect size 0.130, P = 0.05). Therefore, PI-based therapy results in superior CD4 T-cell gains compared with switching to a non-PI regimen.