医学
替诺福韦
人类免疫缺陷病毒(HIV)
药理学
抗逆转录病毒治疗
病毒载量
病毒学
抗逆转录病毒疗法
作者
Carmen Busca,D. Ortega‐González,Mariana Díaz‐Almirón,Marisa Montes,Luz Martín‐Carbonero,Rafael Micán,Rocío Montejano,Luis Ramos‐Ruperto,Eulalia Valencia,Ana Delgado‐Hierro,José I. Bernardino
出处
期刊:Hiv Medicine
[Wiley]
日期:2024-05-15
卷期号:25 (9): 1030-1039
摘要
Abstract Background Studies on switching to tenofovir alafenamide (TAF)‐based regimens raise concerns about a worse metabolic profile in people with HIV, even though most received tenofovir disoproxil fumarate (TDF) in their previous regimen. This study aims to evaluate changes in lipid fractions, glucose, and serum markers for hepatic steatosis (HS) after switching from a TDF‐ or TAF‐sparing regimen to bictegravir/emtricitabine/TAF (B/F/TAF). Methods We performed a retrospective cohort study of people with HIV who switched to B/F/TAF from TDF‐ or TAF‐sparing regimens between January 2019 and May 2022 with at least 6 months of follow‐up. The primary endpoint was the absolute change in lipid fractions at 6 months. Secondary outcomes were changes in lipid fractions at 12 months and changes in other metabolic parameters (glucose, creatinine, and HS based on the triglyceride‐to‐glucose [TyG] ratio at 6 and 12 months). Changes were analysed using mixed linear regression models with random intercept and time as a fixed effect. Results The study included 259 people with HIV (median age 55 [interquartile range (IQR) 47–60] years; 80% male; 88% Caucasian; CD4+ T‐cell count 675 [IQR 450–880] cells/mm 3 ; 84.3% HIV‐RNA <50 copies/mL). In total, 63 patients (30%) had hypertension, 93 (44%) dyslipidaemia, 30 (14%) diabetes, and 45% obesity/overweight. Most (60%) switched from integrase inhibitor‐based regimens, and 21% switched from a boosted regimen. At 6 months, significant reductions were observed in total cholesterol (−7.64 mg/dL [95% confidence interval (CI) −13.52 to −1.76; p = 0.002]), triglycerides (−23.4 [95% CI −42.07 to −4.65]; p = 0.003), and TyG ratio (−0.14 [95% CI −0.23 to −0.05]; p < 0.001). Conclusion In our real‐life cohort, the effect of switching TDF‐/TAF‐sparing regimens to triple therapy with B/F/TAF improved total cholesterol, triglycerides, and serum markers of HS at 6 months and was neutral for the remaining metabolic parameters at 12 months.
科研通智能强力驱动
Strongly Powered by AbleSci AI