While tenofovir is widely used for the treatment of chronic hepatitis B virus infection, it is also known to be a potent inhibitor of human telomerase. The authors performed a a randomised controlled trial to explore the non-inferiority of ritonavir-boosted darunavir plus raltegravir versus tenofovir disoproxil fumarate/emtricitabine over 96 weeks in 805 antiretroviral-naive HIV-infected adults. During this study they examined changes in whole-blood telomere length measured with qPCR in 201 randomly selected patients (104 raltegravir and 97 tenofovir disoproxil fumarate/emtricitabine). The authors found that at week 96, patients on tenofovir disoproxil fumarate/emtricitabine had a significantly higher increase in telomere length than patients receiving raltegravir. The difference in mean telomere length change between groups (tenofovir disoproxil fumarate/emtricitabine minus raltegravir) from baseline to week 96, adjusted by baseline telomere length, was 0.031. This difference was not significantly affected by age, gender, known duration of HIV infection, CD4+ T cell count (baseline/nadir), CD8+ T cell count, CD4/CD8 ratio, HIV viral load (baseline/week 96), tobacco and alcohol consumption, statins, or hepatitis C virus co-infection. Therefore antiretroviral-naive HIV-infected adults receiving ritonavir-boosted darunavir and tenofovir disoproxil fumarate/emtricitabine experience a significant higher increase in blood telomere length than those receiving ritonavir-boosted darunavir and raltegravir, suggesting a better initial recovery from HIV-associated immunosenescence.
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