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.
Adult
Anti-HIV Agents
/ metabolism
Body Weight
/ drug effects
Cohort Studies
Dideoxynucleosides
/ metabolism
Drug Combinations
Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
/ metabolism
Emtricitabine, Rilpivirine, Tenofovir Drug Combination
/ metabolism
Female
HIV Infections
/ drug therapy
Heart Disease Risk Factors
Heterocyclic Compounds, 3-Ring
/ metabolism
Humans
Italy
/ epidemiology
Lamivudine
/ metabolism
Lipid Metabolism
/ drug effects
Lipids
/ blood
Male
Middle Aged
Oxazines
/ metabolism
Piperazines
/ metabolism
Pyridones
/ metabolism
Retrospective Studies
Tablets
/ therapeutic use
Cardiovascular risk
Cholesterol
Framingham score
Integrase inhibitors
Rilpivirine
Single tablet regimens
Tenofovir alafenamide
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
22 Jun 2021
22 Jun 2021
Historique:
received:
22
12
2020
accepted:
08
06
2021
entrez:
23
6
2021
pubmed:
24
6
2021
medline:
6
7
2021
Statut:
epublish
Résumé
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. 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. 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]. 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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
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.
Identifiants
pubmed: 34157984
doi: 10.1186/s12879-021-06304-3
pii: 10.1186/s12879-021-06304-3
pmc: PMC8220746
doi:
Substances chimiques
Anti-HIV Agents
0
Dideoxynucleosides
0
Drug Combinations
0
Elvitegravir, Cobicistat, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
0
Emtricitabine, Rilpivirine, Tenofovir Drug Combination
0
Heterocyclic Compounds, 3-Ring
0
Lipids
0
Oxazines
0
Piperazines
0
Pyridones
0
Tablets
0
abacavir, lamivudine drug combination
0
Lamivudine
2T8Q726O95
dolutegravir
DKO1W9H7M1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
595Références
J Antimicrob Chemother. 2011 Mar;66(3):682-3
pubmed: 21131692
N Engl J Med. 2007 Apr 26;356(17):1723-35
pubmed: 17460226
Lancet HIV. 2018 Jan;5(1):e23-e34
pubmed: 28993180
Curr Infect Dis Rep. 2018 May 26;20(8):20
pubmed: 29804227
AIDS. 2003 Jun 13;17(9):1329-38
pubmed: 12799554
HIV Med. 2019 Feb;20(2):164-168
pubmed: 30457197
AIDS Res Hum Retroviruses. 2018 Apr;34(4):337-342
pubmed: 29368537
Open Forum Infect Dis. 2020 May 26;7(6):ofaa195
pubmed: 32577427
AIDS Res Hum Retroviruses. 2021 Jun;37(6):461-467
pubmed: 33231474
Clin Infect Dis. 2007 Oct 15;45(8):1074-81
pubmed: 17879928
Drug Des Devel Ther. 2019 Jul 09;13:2271-2282
pubmed: 31371921
AIDS. 2010 Jul 17;24(11):1781-4
pubmed: 20495438
J Clin Transl Endocrinol. 2017 Feb 22;8:6-14
pubmed: 29067253
J Virus Erad. 2019 Jan 1;5(1):41-43
pubmed: 30800425
Circulation. 2008 Feb 12;117(6):743-53
pubmed: 18212285
AIDS. 1998 May 7;12(7):F51-8
pubmed: 9619798
J Antimicrob Chemother. 2020 Nov 1;75(11):3334-3343
pubmed: 32737482
Ann Intern Med. 2021 Jun;174(6):758-767
pubmed: 33721521
HIV Med. 2018 Nov;19(10):724-733
pubmed: 30101539
Patient. 2015 Jun;8(3):257-67
pubmed: 25808940
BMC Infect Dis. 2018 Jun 5;18(1):258
pubmed: 29866059
Circulation. 2019 Jul 9;140(2):e98-e124
pubmed: 31154814
Int J Infect Dis. 2020 Mar;92:71-77
pubmed: 31884172
J Infect. 2017 Apr;74(4):401-407
pubmed: 28143756
AIDS Rev. 2018;20(3):141-149
pubmed: 30264826
BMC Infect Dis. 2017 Jun 12;17(1):414
pubmed: 28606059
AIDS Res Ther. 2019 May 24;16(1):11
pubmed: 31126301
ScientificWorldJournal. 2013 Oct 21;2013:969281
pubmed: 24228022
Clin Infect Dis. 2019 Feb 1;68(4):597-606
pubmed: 29912307
Antivir Ther. 2017;22(5):459-460
pubmed: 28901945
Am Heart J. 2019 Mar;209:79-87
pubmed: 30685678
New Microbiol. 2015 Oct;38(4):443-90
pubmed: 26571377
AIDS. 2013 Mar 27;27(6):973-979
pubmed: 23698063
J Acquir Immune Defic Syndr. 2017 Dec 15;76(5):527-531
pubmed: 28825943
Clin Infect Dis. 2011 Oct;53(8):807-16
pubmed: 21921224
Am J Kidney Dis. 2011 May;57(5):773-80
pubmed: 21435764
J Acquir Immune Defic Syndr. 2004 Jul 1;36(3):808-16
pubmed: 15213564
J Acquir Immune Defic Syndr. 2018 Jan 1;77(1):86-92
pubmed: 28961682