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. 2024 Dec 18;7(12):e70275.
doi: 10.1002/hsr2.70275. eCollection 2024 Dec.

Metabolic Outcomes of Changing From Rilpivirine/Tenofovir Disoproxil Fumarate/Emtricitabine to Rilpivirine/Tenofovir Alafenamide/Emtricitabine: A Longitudinal Study

Ping-Feng Wu  1   2   3 , Hsi-Hsun Lin  3   4 , Hsin-Pai Chen  1   2 , Po-Chieh Huang  1 , Meng-Yu Ke  1
Affiliations

Metabolic Outcomes of Changing From Rilpivirine/Tenofovir Disoproxil Fumarate/Emtricitabine to Rilpivirine/Tenofovir Alafenamide/Emtricitabine: A Longitudinal Study

Ping-Feng Wu et al. Health Sci Rep. .

Abstract

Background and aims: People living with human immunodeficiency virus (HIV, PLWH) are aging, and there are growing concerns regarding combined antiretroviral therapy (cART)-associated negative metabolic consequences. We aimed to investigate the metabolic outcomes of PLWH by replacing rilpivirine (RPV)/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) with RPV/tenofovir alafenamide (TAF)/FTC.

Methods: This retrospective study enrolled PLWH who changed from RPV/TDF/FTC to RPV/TAF/FTC between January 2019 and September 2023. Metabolic profiles were compared 1 year before and 3 years after changing cART using Cochran's Q and one-way ANOVA. The independent risk factors for metabolic syndrome were analyzed using logistic regression.

Results: A total of 182 patients were enrolled. The prevalence of metabolic syndrome has increased from 28% to 40.7%. The prevalence of hypertension and abnormal lipid levels significantly increased in the first year after changing cART, but the prescription of medicine for dyslipidemia increased in the second year (p = 0.025) and that for hypertension increased in the third year (p < 0.001). In addition to the criteria, body mass index (BMI) before changing cART was the only predictor of metabolic syndrome in the third year (OR 1.36; 95% CI 1.19-1.55; p < 0.001). The prevalence of metabolic syndrome and BMI did not increase significantly during the second and third years.

Conclusions: A gradually higher prevalence of metabolic syndrome among PLWH occurred with changes from RPV/TDF/FTC to RPV/TAF/FTC but plateaued beyond 2 years. However, fewer drugs for dyslipidemia, diabetes, and hypertension were prescribed within the first year after changing cART.

Keywords: HIV; lipids; metabolic syndrome; tenofovir alafenamide; tenofovir disoproxil fumarate.

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Conflict of interest statement

The authors declare no conflicts of interest.

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