ArticleFrontiers in immunology2026
Adjunctive albuvirtide is associated with improved immune recovery in treatment-naive patients with advanced HIV disease receiving bictegravir/emtricitabine/tenofovir alafenamide: a retrospective propensity score-matched cohort study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Treatment-naive patients with advanced HIV infection may have incomplete immune reconstitution despite effective antiretroviral therapy (ART). We evaluated whether adjunctive albuvirtide (ABT) added to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) was associated with improved 24-week immune recovery and short-term safety. Methods: This single-center retrospective cohort included adults with baseline CD4+ T-cell counts <200 cells/μL who initiated ABT+B/F/TAF or B/F/TAF alone. Variable-ratio propensity score matching (up to 1:2) yielded 86 patients (33 receiving ABT+B/F/TAF and 53 receiving B/F/TAF). The primary endpoint was a composite of a CD4+ T-cell increase >150 cells/μL and HIV RNA <50 copies/mL at week 24. Secondary outcomes included virological suppression, changes in CD4+ T-cell count and CD4/CD8 ratio, and documented adverse events. A multivariable sensitivity analysis was performed in the complete unmatched cohort (N = 124). Results: The composite endpoint was achieved more frequently with ABT+B/F/TAF than with B/F/TAF alone (45.5% vs. 22.6%, P = 0.027). The median CD4+ T-cell increase was also greater (165 vs. 106 cells/μL, P = 0.005). HIV RNA <20 copies/mL occurred in 75.8% versus 54.7% of patients, but the difference did not meet the prespecified significance threshold (P = 0.050). In the complete cohort, ABT+B/F/TAF remained associated with immune recovery after multivariable adjustment (adjusted OR = 6.355, 95% CI: 1.539-26.244; P = 0.011). Documented adverse events were similar between groups (54.5% vs. 50.9%, P = 0.732). No Grade ≥3 adverse events, treatment-related adverse events, or adverse-event-related treatment modifications were documented. Conclusion: Adjunctive ABT was associated with greater short-term immune recovery without an apparent increase in documented adverse events. The retrospective design, limited matched sample, residual confounding, and 24-week follow-up preclude causal inference. These findings require confirmation in prospective randomized trials.
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