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. 2022 Oct 1;36(12):1689-1696.
doi: 10.1097/QAD.0000000000003314. Epub 2022 Jul 15.

Tenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV

Guilin Li  1   2 , Lesley S Park  3 , Sara Lodi  1   4 , Roger W Logan  1   2 , Emily J Cartwright  5   6 , Lydia Aoun-Barakat  7 , Juan P Casas  8   9   10 , Barbra A Dickerman  1   2 , Christopher T Rentsch  11   12   13 , Amy C Justice  12   14   15 , Miguel A Hernán  1   2   16
Affiliations

Tenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV

Guilin Li et al. AIDS. .

Abstract

Objective: To compare the risk of coronavirus disease 2019 (COVID-19) outcomes by antiretroviral therapy (ART) regimens among men with HIV.

Design: We included men with HIV on ART in the Veterans Aging Cohort Study who, between February 2020 and October 2021, were 18 years or older and had adequate virological control, CD4 + cell count, and HIV viral load measured in the previous 12 months, and no previous COVID-19 diagnosis or vaccination.

Methods: We compared the adjusted risks of documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission by baseline ART regimen: tenofovir alafenamide (TAF)/emtricitabine (FTC), tenofovir disoproxil fumarate (TDF)/FTC, abacavir (ABC)/lamivudine (3TC), and other. We fit pooled logistic regressions to estimate the 18-month risks standardized by demographic and clinical factors.

Results: Among 20 494 eligible individuals, the baseline characteristics were similar across regimens, except that TDF/FTC and TAF/FTC had lower prevalences of chronic kidney disease and estimated glomerular filtration rate <60 ml/min. Compared with TAF/FTC, the estimated 18-month risk ratio (95% confidence interval) of documented SARS-CoV-2 infection was 0.65 (0.43, 0.89) for TDF/FTC, 1.00 (0.85, 1.18) for ABC/3TC, and 0.87 (0.70, 1.04) for others. The corresponding risk ratios for COVID-19 hospitalization were 0.43 (0.07, 0.87), 1.09 (0.79, 1.48), and 1.21 (0.88, 1.62). The risk of COVID-19 ICU admission was lowest for TDF/FTC, but the estimates were imprecise.

Conclusion: Our study suggests that, in men living with HIV, TDF/FTC may protect against COVID-19-related events. Randomized trials are needed to investigate the effectiveness of TDF as prophylaxis for, and early treatment of, COVID-19 in the general population.

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Figures

Appendix Figure 1.
Appendix Figure 1.
Comparison of trends of COVID-19 cases in the study population and in the United States
Appendix Figure 2.
Appendix Figure 2.
The number of SARS-CoV-2 tests proportional to persons under follow-up in each month by treatment groups
Figure 1.
Figure 1.
Flowchart of eligible persons with HIV, Veterans Aging Cohort Study, February 2020 – October 2021
Figure 2.
Figure 2.
Standardized 18-month cumulative risk curves for COVID-19 outcomes by NRTI combination in men with HIV, Veterans Aging Cohort Study, February 2020 – October 2021
See this image and copyright information in PMC

References

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    1. Del Amo J, Polo R, Moreno S, Martínez E, Cabello A, Iribarren J, et al. Tenofovir Disoproxil Fumarate and severity of COVID-19 in people with HIV infection [preprint] medRxiv 2021:2021.2011.2011..
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