Impact of switching to tenofovir alafenamide on weight gain as compared to maintaining a non-tenofovir alafenamide containing regimen.
Impact of switching to tenofovir alafenamide on weight gain as compared to maintaining a non-tenofovir alafenamide containing regimen.
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DOI：
10.1097/md.0000000000027047
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发表时间：
2021-08-27
期刊：
影响因子：
1.6
通讯作者：
Hill LA
中科院分区：
文献类型：
--
作者：
Darnell J;Jain S;Sun X;Qin H;Reynolds T;Karris MY;Hill LA
评价转换为含替诺福韦艾拉酚胺（TAF）的抗逆转录病毒治疗方案与继续使用不含TAF的治疗方案相比对体重和代谢并发症发生的影响。单中心回顾性病例对照研究。我们评估了人类免疫缺陷病毒（PLWH）感染者，他们正在接受不含TAF的抗逆转录病毒治疗方案，并在2016年1月1日至2018年9月30日期间转换为含TAF的治疗方案。对照组包括在整个研究期间接受无TAF方案的PLWH。主要结局是体重从基线到转换后12个月的变化。次要结果包括研究期间体重的百分比变化、体重指数（BMI）的变化、BMI等级的变化以及糖尿病、高血压和高脂血症（HLD）的新诊断。与对照组（n = 162）相比，PLWH转换为TAF（n =446）显示出显著更大的平均体重增加（1.97 vs 0.88 kg，P = 0.01），然而，仅在从富马酸替诺福韦酯转换的患者中观察到这种效果。 那些转换为TAF的人也有显着更高的体重增加百分比，BMI增加和BMI等级。在研究期间，我们观察到对照组中HLD的新诊断率高于TAF转换组。与继续接受无TAF方案的患者相比，PLWH转为TAF治疗1年后体重增加更大。然而，这并没有转化为随访期间肥胖相关疾病（如糖尿病，高血压和HLD）的较高发病率。
Evaluate the impact of switching to an anti-retroviral regimen containing tenofovir alafenamide (TAF) on weight and the development of metabolic complications compared to remaining on a non-TAF containing regimen. Single-center retrospective case-control study. We evaluated people living with human immunodeficiency virus (PLWH) who were on an anti-retroviral regimen not containing TAF and were switched to a regimen containing TAF between January 1, 2016 and September 30, 2018. The control group included PLWH on a TAF free regimen throughout the study period. The primary outcome was change in weight from baseline to 12 months postswitch. Secondary outcomes included percent change in weight, change in body mass index (BMI), change in BMI class, and new diagnoses of diabetes, hypertension, and hyperlipidemia (HLD) during the study period. PLWH switched to TAF (n = 446) demonstrated significantly greater mean increase in weight compared to the control group (n = 162) (1.97 vs 0.88 kg, P = .01), however the effect was only seen in those switched from tenofovir disoproxil fumarate. Those that switched to TAF also had a significantly higher percent increase in weight, increase in BMI, and BMI class. We observed a higher rate of new diagnosis of HLD in the control group compared to the TAF switch group during the study period. PLWH switched to TAF had greater increases in weight after 1 year as compared to those continuing on a TAF free regimen. However, this did not translate to higher rates of obesity related illnesses such as diabetes, hypertension, and HLD during the follow up period.