Lipid Changes After Switch From TDF to TAF in the OPERA Cohort: LDL Cholesterol and Triglycerides

Mallon, Patrick; Brunet, Laurence; Fusco, Jennifer S; Prajapati, Girish; Beyer, A; Fusco, Gregory; Wohlfeiler, Michael

doi:10.1093/ofid/ofab621

Cited by 27 publications

(18 citation statements)

References 36 publications

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“…On the other hand, HIV-infected patients have to use lifelong antiretroviral drugs that have to be optimized to reduce long-term metabolic impact. Regarding antiretroviral therapy (ART), there are many data in the literature on dyslipidemia associated with a switch from TDF to TAF in treatment-experienced HIV patients [ 5 , 6 , 7 , 8 ]. In particular, in a recent real-world study on 6423 HIV-experienced patients, Brunet et al showed a development of dyslipidemia associated however to an underutilization of statin after switching from TDF to TAF [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the introduction of tenofovir alafenamide (TAF) has deeply modified the choice of the backbone, allowing the prevention of bone and renal toxicity related to previous formulations of tenofovir disoproxil fumarate (TDF) [ 1 , 2 , 3 , 4 ]. However, some evidence suggests that the switch from TDF to TAF could be associated with a higher incidence of dyslipidemia [ 5 , 6 , 7 , 8 ]; this could be due to a “statin-like” effect of TDF, as clinical trials and real-life studies suggest [ 9 ]. In some publications, dyslipidemia, after this switch, was associated with higher cardiovascular risk [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Dynamics of Lipid Profile in Antiretroviral-Naïve HIV-Infected Patients, Treated with TAF-Based Regimens: A Multicenter Observational Study

et al. 2022

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Background: The introduction of tenofovir alafenamide (TAF) in antiretroviral therapy has deeply modified the choice of the backbone for different treatment regimens, allowing the prevention of the bone and renal toxicity that was related to the previous formulation of tenofovir disoproxil fumarate (TDF). At the same time, literature data show an onset of dyslipidemia after a switch from TDF to TAF. To better understand the possible role of TAF in dyslipidemia, antiretroviral-naïve HIV-infected patients were evaluated, comparing those treated with TAF/emtricitabine with those with abacavir/lamivudine. Methods: We enrolled 270 antiretroviral-naïve HIV-infected patients in an observational, retrospective, longitudinal, multicenter study; they started treatment from 2017 to 2019 and were followed up for at least 72 weeks. We divided patients into two groups, one treated with a TAF-based backbone in their antiretroviral regimens (TAF group) and one without TAF (NO TAF group), to evaluate possible differences in the dynamics of lipid profiles from baseline(T0) to week 24 (T24), 48 (T48) and 72 (T72). Results: No significant differences were observed at baseline between the 2 groups. In the TAF group we observed a significant development of hypercholesterolemia throughout the follow-up (p < 0.0001), not evident in the NO TAF group, that instead showed a significant increase in high-density lipoprotein (HDL). There were no significant differences between the two groups regarding triglycerides, low-density lipoprotein (LDL) and cardiovascular risk index (CRI). A cholesterol-lowering treatment with statin, finally, was prescribed in 6 patients in both groups during the study. At binary logistic regression analysis, no factor was independently associated with hypercholesterolemia, except for higher age at T0. Conclusions: This real-life study shows that in HIV-naïve patients, TAF was associated with hypercholesterolemia throughout the follow-up. The clinical significance of this hypercholesterolemia will have to be clarified in further studies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamics of Lipid Profile in Antiretroviral-Naïve HIV-Infected Patients, Treated with TAF-Based Regimens: A Multicenter Observational Study

et al. 2022

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“…Although the mechanism is unclear, an association between TDF and a decrease in lipid levels has been reported in several studies (23)(24)(25). In a study conducted by Malloon et al (26) examining the lipid profile of patients who were switched from TDF to TAF, an increase in LDL and triglyceride levels was observed after 9-16 months. In our study, an increase in total cholesterol, LDL and triglyceride levels and a decrease in HDL levels were found in patients whose lipid profile was monitored, but no statistically significant difference was found (p>0.05).…”

Section: Discussionmentioning

confidence: 96%

Evaluation of the safety and antiviral efficacy of the tenofovir alafenamide fumarate molecule in immunosuppressed patients

Durak¹,

Coşar

2022

Journal of Health Sciences and Medicine

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Aim: Patients with chronic or prior hepatitis B virus (HBV) infection may experience HBV reactivation during immunosuppressive therapy. The objective of this study was to evaluate the safety and antiviral efficacy of tenofovir alafenamide fumarate (TAF) for prophylaxis of HBV reactivation in patients on immunosuppressive therapy. Material and Method: This study included patients who were started on immunosuppressive treatment due to hematologic/solid malignancy, autoimmune disease, or inflammatory disease and were treated with TAF for at least six months due to HBsAg and/or total anti-HBc positivity at Karadeniz Technical University Farabi Hospital between January 2018 and February 2021. Electronic medical records were retrospectively reviewed and the adverse event profile was analyzed. Results: Of the 94 patients enrolled in the study, 70.2% (n=66) were male. The mean age of the patients was 60.37±14.56 years. The reasons for initiation of immunosuppressive drug treatment were hematologic malignancies in 48.9% (n=46), solid tumors in 27.7% (n=26), and other causes (autoimmune/inflammatory) in 23.4% (n=22). There was no statistically significant difference in creatinine, phosphorus, glucose, and LDL profile between baseline and 6-12 months of TAF treatment (p=0.861, p=0.136, p=0.323, p=0.304, respectively). All patients in whom HBV DNA was detectable at baseline became negative at the last follow-up visit. None of the patients developed HBV reactivation and there was no need to discontinue antiviral/immunosuppressive treatment due to side effects. Conclusion: TAF is a safe and effective short-term option to prevent HBV reactivation in patients receiving immunosuppressive therapy.

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“…We report a high prevalence of MetS and central obesity among females irrespective of HIV status in an urban population in Zambia and Zimbabwe. The rollout of DTG and tenofovir alafenamide, which have been linked to weight increases and worsening lipid profiles among PLWH, could further exacerbate the burden of metabolic complications in the region [ 29 , 30 , 31 ]. As approximately 90% of PLWH in our study initiated a DTG‐containing regimen, the prospective monitoring of metabolic parameters in our study will improve our knowledge on the impact of contemporary ART on associated comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis

et al. 2022

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Introduction Chronic viral replication has been linked to an increased risk of cardiovascular and metabolic diseases in people living with HIV (PLWH), but few studies have evaluated this association in Southern Africa. We explored the determinants of metabolic syndrome (MetS) among treatment‐naïve adults living with and without HIV in Southern Africa. Methods Treatment‐naïve PLWH and people living without HIV (PLWOH) ≥30 years were consecutively enrolled from primary care clinics in Zambia and Zimbabwe. PLWOH were seronegative partners or persons presenting for HIV testing. We defined MetS as the presence of central obesity plus any two of the following: raised blood pressure, impaired fasting glucose, reduced high‐density lipoprotein cholesterol and raised triglycerides, as defined by the International Diabetes Federation. We used logistic regression to determine factors associated with MetS. Results Between August 2019 and March 2022, we screened 1285 adults and enrolled 420 (47%) PLWH and 481 (53%) PLWOH. The median age was similar between PLWH and PLWOH (40 vs. 38 years, p < 0.24). In PLWH, the median CD4 + count was 228 cells/mm 3 (IQR 108–412) and the viral load was 24,114 copies/ml (IQR 277–214,271). Central obesity was present in 365/523 (70%) females and 57/378 males (15%). MetS was diagnosed in 172/901 (19%, 95% confidence interval [CI] 17–22%), and prevalence was higher among females than males (27% vs. 9%). In multivariable analyses, HIV status was not associated with MetS (adjusted odds ratio [aOR] 1.05, 95% CI 0.74–1.51). Risk factors for MetS included age older than 50 years (aOR 2.31, 95% CI 1.49–3.59), female sex (aOR 3.47, 95% CI 2.15–5.60), highest income (aOR 2.19, 95% CI 1.39–3.44) and less than World Health Organization recommended weekly physical activity (aOR 3.35, 95% CI 1.41–7.96). Conclusions We report a high prevalence of MetS and central obesity among females in urban Zambia and Zimbabwe. Lifestyle factors and older age appear to be the strongest predictors of MetS in our population, with no evident difference in MetS prevalence between treatment‐naïve PLWH and PLWOH.

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Lipid Changes After Switch From TDF to TAF in the OPERA Cohort: LDL Cholesterol and Triglycerides

Cited by 27 publications

References 36 publications

Dynamics of Lipid Profile in Antiretroviral-Naïve HIV-Infected Patients, Treated with TAF-Based Regimens: A Multicenter Observational Study

Dynamics of Lipid Profile in Antiretroviral-Naïve HIV-Infected Patients, Treated with TAF-Based Regimens: A Multicenter Observational Study

Evaluation of the safety and antiviral efficacy of the tenofovir alafenamide fumarate molecule in immunosuppressed patients

Metabolic syndrome among treatment‐naïve people living with and without HIV in Zambia and Zimbabwe: a cross‐sectional analysis

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