Weight, Anthropometric and Metabolic Changes After Discontinuing Antiretroviral Therapy Containing Tenofovir Alafenamide (TAF) in People With Human Immunodeficiency Virus (HIV)

被引：10

作者：

Damas, Jose ^{[1
]}

Munting, Aline ^{[1
]}

Fellay, Jacques ^{[2
,3
]}

Haerry, David ^{[4
]}

Marzolini, Catia ^{[5
,6
]}

Tarr, Philip E. ^{[7
]}

Steffen, Ana ^{[8
]}

Braun, Dominique L. ^{[9
]}

Stoeckle, Marcel ^{[5
]}

Bernasconi, Enos ^{[10
,11
]}

Tshikung, Olivier Nawej ^{[12
]}

Fux, Christoph A. ^{[13
]}

Darling, Katharine E. A. ^{[1
]}

Beguelin, Charles ^{[14
]}

Wandeler, Gilles ^{[14
]}

Cavassini, Matthias ^{[1
]}

Surial, Bernard ^{[14
]}

机构：

[1] Univ Lausanne, Univ Hosp Lausanne, Infect Dis Serv, Rue Bugnon 46, CH-1011 Lausanne, Switzerland

[2] Ecole Polytech Fed Lausanne, Sch Life Sci, Lausanne, Switzerland

[3] Univ Hosp, Biomed Data Sci Ctr, Lausanne, Switzerland

[4] Chair Posit Council, Zurich, Switzerland

[5] Univ Basel, Univ Hosp Basel, Div Infect Dis & Hosp Epidemiol, Basel, Switzerland

[6] Univ Hosp Lausanne, Serv Clin Pharmacol, Lausanne, Switzerland

[7] Univ Basel, Univ Dept Med, Kantonsspital Bruderholz, Basel, Switzerland

[8] Cantonal Hosp St Gallen, Div Infect Dis, Infect Prevent & Travel Med, St Gallen, Switzerland

[9] Univ Zurich, Univ Hosp Zurich, Dept Infect Dis & Hosp Epidemiol, Zurich, Switzerland

[10] Univ Geneva, Div Infect Dis, Ente Osped Cantonale, Lugano, Switzerland

[11] Univ Southern Switzerland, Lugano, Switzerland

[12] Univ Geneva, Univ Hosp Geneva, Div Infect Dis, Geneva, Switzerland

[13] Cantonal Hosp Aarau, Div Infect Dis, Aarau, Switzerland

[14] Univ Bern, Bern Univ Hosp, Dept Infect Dis, Inselspital, Freiburgstr 20, CH-3010 Bern, Switzerland

来源：

CLINICAL INFECTIOUS DISEASES | 2024年 / 79卷 / 04期

基金：

瑞士国家科学基金会;

关键词：

antiretroviral therapy; tenofovir alafenamide; tenofovir disoproxil fumarate; weight; HIV; DISOPROXIL FUMARATE;

D O I：

10.1093/cid/ciae189

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background Antiretroviral therapy (ART)-related weight gain is of particular concern in people with HIV (PWH). Although weight gain was observed among PWH receiving tenofovir alafenamide (TAF), little is known about the potential reversibility after TAF discontinuation. We evaluated weight and metabolic changes 12 months after TAF discontinuation in the Swiss HIV Cohort Study.Methods We included participants who received at least 6 months of TAF-containing ART between January 2016 and March 2023. Using multivariable mixed-effect models, changes in weight and lipid levels were compared between individuals who continued TAF and those who switched to one of the following TAF-free regimens: (1) tenofovir disoproxil fumarate (TDF)-based ART, (2) dolutegravir/lamivudine (DTG/3TC), or (3) long-acting cabotegravir/rilpivirine (CAB/RPV).Results Of 6555 participants (median age 54 years, 24.3% female, 13% Black), 5485 (83.7%) continued, and 1070 (16.3%) stopped TAF. Overall, discontinuing TAF was associated with an adjusted mean weight change of -0.54 kg (95% confidence interval [CI] -.98 to -.11) after 12 months. In stratified analyses, switching from TAF to TDF led to an adjusted mean weight decrease of -1.84 kg (95% CI -2.72 to -.97), and to a decrease in mean total cholesterol (-0.44 mmol/L) and triglycerides (-0.38 mmol/L) after 12 months. Switching from TAF-based ART to DTG/3TC (-0.17 kg, 95% CI -.82 to .48) or long-acting CAB/RPV (-0.64 kg, 95% CI -2.16 to .89) did not lead to reductions in weight.Conclusions Replacing TAF with TDF in PWH led to a decrease in body weight and an improved lipid profile within 1 year. Weight changes were not observed among individuals who switched to DTG/3TC or long-acting CAB/RPV. In the Swiss HIV Cohort Study, replacing tenofovir alafenamide (TAF) with tenofovir disoproxil fumarate (TDF) resulted in a -1.84 kg weight decrease within 1 year. No substantial weight changes were noted after switching from TAF to dolutegravir/lamivudine or cabotegravir/rilpivirine. Graphical Abstract

引用

页码：990 / 998

页数：9

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