Tenofovir Alafenamide Fumarate therapy in HIV-infected patients: impact on the metabolic profile and cardiovascular risk. A retrospective study

Current combination antiretroviral therapy (cART) use prolonged significantly HIV patients’ lifespan, indeed nowadays is almost the same as the general population. However, this improvement in life expectancy is coupled to an increase of comorbidities too, between these, dislipidemia, weight gain and alterations of glucose metabolism continue to be of special concern. Such comorbidities are partly due to the infection itself, but also to the pharmacological regimen, in particular, since Tenofovir-based antiretroviral therapy (ART) has become first-line in all major HIV treatment guidelines, it becomes of utmost importance to evaluate the impact of therapeutic regimens containing TAF on the patient’s metabolic profile. The aim of this study was to assess changes in the metabolic profile and cardiovascular risk, evaluated through the Framingham and ASCVD scores, in PLWH switching from TDF-based to TAF-based cART, independently of the third agent. We retrospectively analyzed changes in lipid and glucose levels, weight, HIV variables, and comorbidities in 110 PLWH with a therapeutical regimen containing TAF. Inclusion criteria were as follows: PLWH that switched from TDF-based to TAF-based regimen at the start of the observational period and continued with TAF for at least 6 months. From the switch onwards, predictors of metabolic profile and cardiovascular risk changes were collected and analyzed every 6 months. Predictors of weight gain and body composition changes were analyzed in a multivariable regression model including baseline and follow up demographic, anthropometric, HIV related and comorbidities values.