Long-term trajectories of hepatic and metabolic biomarkers after switching from tenofovir disoproxil fumarate to tenofovir alafenamide in antiretroviral therapy-experienced people with HIV with and without hepatic coinfection: Data from the ICONA cohort

•Hepatic injury markers declined over 2 years after switching from tenofovir disoproxil fumarate to tenofovir alafenamide in people with HIV.•Reduction was stronger in patients with hepatitis B surface antigen+ and those with baseline chronic enzyme elevation.•Lipid parameters increased mainly in th...

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Vydáno v:International journal of infectious diseases Ročník 161; s. 108081
Hlavní autoři: Poliseno, Mariacristina, Caputo, Sergio Lo, Tavelli, Alessandro, Gagliardini, Roberta, Gazzola, Lidia, Saracino, Annalisa, Santantonio, Teresa Antonia, Squillace, Nicola, Puoti, Massimo, Mazzotta, Valentina, Antinori, Adndrea, d’Arminio Monforte, Antonella, Cozzi-Lepri, Alessandro
Médium: Journal Article
Jazyk:angličtina
Vydáno: Canada Elsevier Ltd 01.12.2025
Elsevier
Témata:
Adenine - analogs & derivatives
Adenine - therapeutic use
Adult
Alanine
Alanine Transaminase - blood
ALT
Anti-HIV Agents - therapeutic use
Biomarkers - blood
Cholesterol
Cohort Studies
Coinfection - drug therapy
Drug Substitution
Female
Hepatitis B - complications
Hepatitis B - drug therapy
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - metabolism
HIV/HBV coinfection
Humans
Infectious Disease
Liver - drug effects
Liver - metabolism
Male
Middle Aged
Pulmonary/Respiratory
Tenofovir - analogs & derivatives
Tenofovir - therapeutic use
Tenofovir alafenamide
Tenofovir disoproxil fumarate
ALT
HIV/HBV coinfection
Tenofovir alafenamide
Tenofovir disoproxil fumarate
Cholesterol
ISSN:1201-9712, 1878-3511
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Popis
Shrnutí:•Hepatic injury markers declined over 2 years after switching from tenofovir disoproxil fumarate to tenofovir alafenamide in people with HIV.•Reduction was stronger in patients with hepatitis B surface antigen+ and those with baseline chronic enzyme elevation.•Lipid parameters increased mainly in the first 6 months post-switch, then stabilized.•No significant lipid profile differences were reported by hepatitis B virus/hepatitis C virus coinfection status.•Except for low-density lipoprotein, hepatic/metabolic biomarker changes stayed normal, with limited clinical impact. Long-term effects of switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) on hepatic, renal, and metabolic parameters remain poorly characterized, especially in people with HIV (PWH) and hepatitis B virus coinfection. We analyzed 24-month trajectories before and after the switch to TDF/TAF in antiretroviral therapy-experienced, virologically suppressed participants from the ICONA cohort, excluding those who started antiviral treatment or had detectable hepatitis C virus-RNA during the study period. Mean values at 18 (T–18) and 6 months (T–6) pre-switch, at switch, and 6, 12, and 24 months post-switch (T+6, T+12, T+24) were assessed using adjusted mixed linear models. At 6 months, alanine aminotransferase (ALT) decreased modestly by –3.05 (–6.42, 0.31) U/l, remaining stable at T+24; similar toother liver damage markers. In participants with chronic liver enzyme elevation, ALT reductions were more marked (–20.5 to –22.6 U/l from T+6 to T+24). Total cholesterol, low-density lipoprotein cholesterol (LDL-Chol), and triglycerides increased by 14.46, 10.70, and 11.56 mg/dl, respectively, at T+6, and then stabilized thereafter. PWH with baseline LDL-Chol <100 mg/dl showed larger LDL increases. Compared with HIV-monoinfected individuals, hepatitis B surface antigen+ individuals had higher ALT and lower estimated glomerular filtration rate on TDF; differences attenuated after switching to TAF (P <0.001 and P = 0.002). No lipid trajectory differences emerged by coinfection status. Greater hepatic improvement was noticed after TDF-to-TAF switch in PWH with hepatitis B virus coinfection, with no differences in lipid increases compared with monoinfected patients.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2025.108081