INFLAMMATORY AND T-CELL HOMEOSTASIS PARAMETERS IN DUAL AND TRIPLE COMBINATION ANTIRETROVIRAL THERAPY (CART) FOR HIV INFECTION

Primary HIV infection (PHI) plays a pivotal role in establishing the viral reservoir, leading to persistent immune activation and inflammation despite combination antiretroviral therapy (cART). While cART has transformed HIV into a manageable chronic condition, it remains unable to eradicate the virus or fully restore immune homeostasis. This study explores two critical aspects of HIV management: (i) the impact of early cART initiation during PHI on inflammation, immune activation, and microbial translocation, and (ii) the effects of innovative therapeutic strategies, including dual cART regimens and long-acting injectable treatments, on immune regulation and T-cell homeostasis. The research is structured around three key objectives: (1) investigating the HIV reservoir, circulating Th1/Th2 cytokines, gut integrity, and microbial translocation in individuals with PHI and chronic HIV infection (CHI) before and after cART initiation; (2) assessing immune parameters, gut barrier dysfunction, and mitochondrial stress in PLWH switching from triple to dual INSTI-based cART; and (3) evaluating T-cell homeostasis and activation in virally suppressed individuals transitioning to the long-acting injectable regimen cabotegravir plus rilpivirine (CAB+RPV). By providing deeper insights into how different treatment strategies affect immune activation and inflammation, this study aims to refine therapeutic approaches and mitigate long-term complications in people living with HIV.