Impact of switching to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG on cardiovascular risk and lipid profile in people living with HIV: a retrospective cohort study

BMC Infectious Diseases

Tiziana Formenti¹  Letizia Oreni¹  Stefano Rusconi²  Federico Conti²  Cecilia Bonazzetti²  Laura Pezzati²  Valentina Morena²  Massimo Galli²  Anna Lisa Ridolfo²  Andrea Giacomelli²  Gabriele Pagani³ 

[1] Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy;Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy;III Infectious Diseases Unit, Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Luigi Sacco Hospital, Legnano (MI), Italy;Department of Infectious Diseases, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy;III Infectious Diseases Unit, Luigi Sacco Department of Biomedical and Clinical Sciences DIBIC, University of Milan, Luigi Sacco Hospital, Legnano (MI), Italy;Infectious Diseases Unit, Legnano General Hospital, ASST Ovest Milanese, Via G.B. Grassi 74, 20157, Milan, Italy;

关键词: Single tablet regimens;    Tenofovir alafenamide;    Framingham score;    Cholesterol;    Cardiovascular risk;    Integrase inhibitors;    Rilpivirine;   

DOI  :  10.1186/s12879-021-06304-3

来源: Springer

【 摘 要 】

BackgroundWe aimed to assess the overall cardiovascular and metabolic effect of the switch to three different single tablet regimens (STRs) [tenofovir alafenamide/emtricitabine/rilpivirine (TAF/FTC/RPV), TAF/FTC/elvitegravir/cobi (TAF/FTC/EVG/cobi) and ABC/lamivudine/dolutegravir (ABC/3TC/DTG)] in a cohort of people living with HIV/AIDS (PLWH) under effective ART.MethodsAll PLWH aged above 18 years on antiretroviral treatment with an HIV-RNA < 50 cp/mL at the time of the switch to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG were retrospectively included in the analysis. Framingham risk score modification after 12 months from the switch such as lipid profile and body weight modification were assessed. The change from baseline to 12 months in mean cardiovascular risk and body weight in each of the STR’s group were assessed by means of Wilcoxon signed-rank test whereas a mixed regression model was used to assess variation in lipid levels.ResultsFive-hundred and sixty PLWH were switched to an STR regimen of whom 170 (30.4%) to TAF/FTC/EVG/cobi, 191 (34.1%) to TAF/FTC/RPV and 199 (35.5%) to ABC/3TC/DTG.No difference in the Framingham cardiovascular risk score was observed after 12 months from the switch in each of the STR’s groups. No significant overtime variation in mean total cholesterol levels from baseline to 12 months was observed for PLWH switched to ABC/3TC/DTG [200 (SD 38) mg/dl vs 201 (SD 35) mg/dl; p = 0.610] whereas a significant increment was observed in PLWH switched to TAF/FTC/EVG/cobi [192 (SD 34) mg/dl vs 208 (SD 40) mg/dl; p < 0.0001] and TAF/FTC/RPV [187 (SD 34) mg/dl vs 195 (SD 35) mg/dl; p = 0.027]. In addition, a significant variation in the mean body weight from baseline to 12 months was observed in PLWH switched to TAF/FTC/EVG/cobi [72.2 (SD 13.5) kilograms vs 74.6 (SD 14.3) kilograms; p < 0.0001] and TAF/FTC/RPV [73.4 (SD 11.6) kilograms vs 75.6 (SD 11.8) kilograms; p < 0.0001] whereas no difference was observed in those switched to ABC/3TC/DTG [71.5 (SD 12.8) kilograms vs 72.1 (SD 12.6) kilograms; p = 0.478].ConclusionNo difference in the cardiovascular risk after 1 year from the switch to these STRs were observed. PLWH switched to TAF/FTC/EVG/cobi and TAF/FTC/RPV showed an increase in total cholesterol levels and body weight 12 months after the switch.

【 授权许可】

CC BY