Metabolic effects of switching to Biktarvy (B/F/TAF) in patients with HIV-1 treated with antiretroviral regimens that do not include tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF): The Metabic study

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-05-15 DOI:10.1111/hiv.13659

C. Busca-Arenzana, D. Ortega-González, M. Díaz-Almirón, M. L. Montes, Luz Martin-Carbonero, R. Mican, R. Montejano, L. Ramos-Ruperto, Eulalia Valencia, Ana Delgado-Hierro, Jose I. Bernardino

{"title":"Metabolic effects of switching to Biktarvy (B/F/TAF) in patients with HIV-1 treated with antiretroviral regimens that do not include tenofovir disoproxil fumarate (TDF) or tenofovir alafenamide (TAF): The Metabic study","authors":"C. Busca-Arenzana, D. Ortega-González, M. Díaz-Almirón, M. L. Montes, Luz Martin-Carbonero, R. Mican, R. Montejano, L. Ramos-Ruperto, Eulalia Valencia, Ana Delgado-Hierro, Jose I. Bernardino","doi":"10.1111/hiv.13659","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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<sup>3</sup>; 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; <i>p</i> = 0.002]), triglycerides (−23.4 [95% CI −42.07 to −4.65]; <i>p</i> = 0.003), and TyG ratio (−0.14 [95% CI −0.23 to −0.05]; <i>p</i> < 0.001).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/hiv.13659","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

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/mm³; 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.

查看原文本刊更多论文

使用不包括富马酸替诺福韦二吡呋酯（TDF）或替诺福韦阿拉非酰胺（TAF）的抗逆转录病毒疗法治疗的 HIV-1 患者改用 Biktarvy（B/F/TAF）后的代谢影响：Metabic研究。

背景：有关转用替诺福韦阿拉非酰胺（TAF）为基础的治疗方案的研究引起了人们对艾滋病患者代谢状况恶化的担忧，尽管大多数人在之前的治疗方案中接受的是富马酸替诺福韦二吡呋酯（TDF）。本研究旨在评估从TDF或TAF保留方案转为比特拉韦/恩曲他滨/TAF（B/F/TAF）方案后血脂、血糖和肝脂肪变性（HS）血清标志物的变化：我们对2019年1月至2022年5月期间从TDF或TAF保留方案转为B/F/TAF且随访至少6个月的HIV感染者进行了一项回顾性队列研究。主要终点是6个月时血脂分数的绝对变化。次要结局是 12 个月时血脂分数的变化以及其他代谢参数（6 个月和 12 个月时基于甘油三酯与葡萄糖 [TyG] 比值的葡萄糖、肌酐和 HS）的变化。采用随机截距和时间作为固定效应的混合线性回归模型对这些变化进行分析：研究纳入了 259 名艾滋病病毒感染者（中位年龄 55 [四分位距（IQR）47-60]岁；80% 为男性；88% 为白种人；CD4+ T 细胞计数 675 [IQR 450-880] cells/mm3; 84.3% HIV-RNA 结论：在我们的现实生活队列中，我们的研究结果表明，在 6 个月和 12 个月的时间内，我们的血脂与血糖（TyG）比值发生了变化：在我们的实际队列中，将TDF/TAF保留方案转换为B/F/TAF三联疗法的效果在6个月时改善了总胆固醇、甘油三酯和HS的血清标志物，在12个月时对其余代谢参数的影响为中性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.

文献相关原料

公司名称	产品信息	采购帮参考价格