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Detection of Low Copy Number Integrated Viral DNA Formed by In Vitro Hepatitis B Infection
Published on: November 7, 2018
HBV status modulates transaminase decrease after switching from tenofovir disoproxil fumarate to tenofovir
Giuseppe Lapadula1,2, Alessandro Soria2, Laura Antolini3
1School of Medicine, University of Milano-Bicocca, Milan, Italy.
Switching HIV patients from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) significantly reduces liver enzymes, particularly in those with chronic hepatitis B. TAF offers a favorable option, but metabolic changes require monitoring.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Tenofovir alafenamide (TAF) switch from tenofovir disoproxil fumarate (TDF) is linked to lower transaminase levels in people with HIV (PWH).
- The impact of HBV serostatus on this TDF to TAF switch effect is not well understood.
Purpose of the Study:
- To assess the effect of switching from TDF to TAF on transaminase levels in PWH.
- To investigate if HBV serostatus modifies the TDF to TAF switch's impact on transaminases.
Main Methods:
- Longitudinal observational study of PWH switching from TDF to TAF (2016-2023).
- Mixed-effects model with random intercepts to analyze transaminase changes.
- Interaction term for HBV status: chronic hepatitis B (HBsAg+), possible occult HBV infection (pOBI), and no HBV.
Main Results:
- Switching to TAF significantly decreased ALT levels (β -3.5 IU/mL).
- Individuals with chronic hepatitis B showed a greater ALT reduction compared to HBV-negative individuals (β -7.5).
- TAF use was linked to weight gain and transient changes in the Hepatic Steatosis Index.
Conclusions:
- Switching from TDF to TAF leads to significant ALT reduction in PWH, especially those with chronic hepatitis B.
- TAF may be a beneficial option for PWH with chronic hepatitis B.
- Potential metabolic effects of TAF necessitate ongoing patient monitoring.
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