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.

Abstract

BACKGROUND:

We 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.

METHODS:

All 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.

RESULTS:

Five-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].

CONCLUSION:

No 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.

• Authors: Andrea Giacomelli, Federico Conti, Laura Pezzati, Letizia Oreni, Anna Lisa Ridolfo, Valentina Morena, Cecilia Bonazzetti, Gabriele Pagani, Tiziana Formenti, Massimo Galli, Stefano Rusconi
• Journal: BMC infectious diseases (BMC Infect Dis) Vol. 21 Issue 1 Pg. 595 (Jun 22 2021) ISSN: 1471-2334 [Electronic] England
• PMID: 34157984 (Publication Type: Journal Article)

Chemical References

• Anti-HIV Agents
• Dideoxynucleosides
• Drug Combinations
• Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
• Emtricitabine, Rilpivirine, Tenofovir Drug Combination
• Heterocyclic Compounds, 3-Ring
• Lipids
• Oxazines
• Piperazines
• Pyridones
• Tablets
• abacavir, lamivudine drug combination
• Lamivudine
• dolutegravir

Topics

• Adult
• Anti-HIV Agents (metabolism, therapeutic use)
• Body Weight (drug effects)
• Cohort Studies
• Dideoxynucleosides (metabolism, therapeutic use)
• Drug Combinations
• Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination (metabolism, therapeutic use)
• Emtricitabine, Rilpivirine, Tenofovir Drug Combination (metabolism, therapeutic use)
• Female
• HIV Infections (drug therapy)
• Heart Disease Risk Factors
• Heterocyclic Compounds, 3-Ring (metabolism, therapeutic use)
• Humans
• Italy (epidemiology)
• Lamivudine (metabolism, therapeutic use)
• Lipid Metabolism (drug effects)
• Lipids (blood)
• Male
• Middle Aged
• Oxazines (metabolism, therapeutic use)
• Piperazines (metabolism, therapeutic use)
• Pyridones (metabolism, therapeutic use)
• Retrospective Studies
• Tablets (therapeutic use)