Rates and predictors of switching to tenofovir alafenamide-containing ART in a nationwide cohort

BMC Infectious Diseases

the Swiss HIV Cohort Study¹  Andri Rauch²  Hansjakob Furrer²  Gilles Wandeler²  Bernard Surial²  Marcel Stöckle³  Helen Kovari⁴  Jan Fehr⁴  Christoph A. Fux⁵  Bianca Roth⁶  Alexandra Calmy⁷  Enos Bernasconi⁸  Matthias Cavassini⁹ 

[1] ;Department of Infectious Diseases, Bern University Hospital, University of Bern;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich;Division of Infectious Diseases, Cantonal Hospital of Aarau;Division of Infectious Diseases, Cantonal Hospital of St Gallen;Division of Infectious Diseases, Geneva University Hospital, University of Geneva;Division of Infectious Diseases, Regional Hospital of Lugano;Division of Infectious Diseases, University Hospital of Lausanne, University of Lausanne;

关键词: Tenofovir alafenamide;    Tenofovir disoproxil fumarate;    Antiretroviral therapy;    Switch;    Toxicity;   

DOI  :  10.1186/s12879-019-4454-9

来源: DOAJ

【 摘 要 】

Abstract Background Tenofovir alafenamide (TAF)-containing combinations were introduced in Switzerland after October 2016 and are recommended over tenofovir disoproxil fumarate (TDF) in patients with osteoporosis or impaired renal function. Methods We included all participants of the Swiss HIV Cohort Study on TDF-containing antiretroviral therapy with follow-up visits after January 2016. We determined the proportion of switches from TDF to TAF overall, and among patients with risk factors for TDF toxicity, including osteoporosis, impaired renal function or marked proteinuria. We used multivariable logistic regression to explore predictors of switching from TDF to TAF. Results We included 5′012 patients, of whom 652 (13.0%) had risk factors for TDF toxicity. A switch from TDF to TAF was undertaken in 2′796 (55.8%) individuals overall, and in 465 (71.3%) with risk factors. Predictors of switching to TAF were male sex (adjusted odds ratio 1.27, 95% confidence interval 1.07–1.50), age > 50 years (1.43, 1.23–1.66) and the presence of risk factors for TDF toxicity (2.21, 1.77–2.75). In contrast, patients with a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based single-pill regimen (0.11, 0.09–0.13), those treated in non-tertiary care centers (0.56, 0.46–0.70), as well as those with CD4 cell counts below 500/μL (0.77, 0.66–0.90) and with chronic hepatitis C infection (0.66, 0.54–0.80) were most likely to stay on TDF. Conclusions Over 50% of patients on TDF-containing therapy, including the majority of patients at risk for TDF toxicity, were switched to TAF within two years of its introduction in Switzerland. Individuals on NNRTI-based single-pill regimens were most likely to remain on TDF.

【 授权许可】

Unknown