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Metabolic Outcomes of Changing From Rilpivirine/Tenofovir Disoproxil Fumarate/Emtricitabine to Rilpivirine/Tenofovir
Ping-Feng Wu1,2,3, Hsi-Hsun Lin3,4, Hsin-Pai Chen1,2
1Division of Infectious Diseases, Department of Medicine Taipei Veterans General Hospital Taipei Taiwan.
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.
