Real-Life Impact on Lipid Profile of a Switch from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in HIV-Infected Patients

Author(s): Jennifer Lagoutte-Renosi*, Mylène Flammang*, Catherine Chirouze, Geneviève Beck-Wirth, Fabienne Bozon, Anne-Sophie Brunel, Marie-Christine Drobacheff-Thiebaut, Adeline Foltzer, Laurent Hustache-Mathieu, Jakub Kowalczyk, Catherine Michel, Siamak Davani, Patrice Muret

Journal Name: Current HIV Research

Volume 19 , Issue 1 , 2021


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Abstract:

Background: Tenofovir disoproxil fumarate is a prodrug of tenofovir diphosphate that exposes patients to renal toxicity over the long term. Tenofovir alafenamide, a new prodrug, now makes it possible to reduce toxicity, but at the cost of an alteration in lipid profile. There is currently no recommendation for follow-up of lipid profile when switching from tenofovir disoproxil fumarate to tenofovir alafenamide.

Objective: Our study aimed to evaluate the effects on renal function and lipid profile of a switch from tenofovir disoproxil fumarate to tenofovir alafenamide, and the consequences for patient management.

Methods: Demographic, clinical and biological data was recorded from a retrospective clinical cohort study in real-life, including patients who switched from tenofovir disoproxil fumarate to tenofovir alafenamide. A descriptive analysis of the study population, with a comparison of biological parameters using the paired Student t test for paired data was performed.

Results: From January 2016 to January 2019, a total of 103 patients were included. There was no significant difference in renal function before vs after the switch in therapy (p=0.29 for creatinine, p=0.30 for phosphoremia). We observed a change in lipid profile, with a significant increase in total cholesterol (p=0.0006), HDL cholesterol (p=0.0055) and triglycerides (p=0.0242). Four patients received lipid-lowering therapy after switching.

Conclusion: In patients who switch from tenofovir disoproxil fumarate to tenofovir alafenamide, lipid profile is altered, and may require initiation of lipid-lowering therapy. It seems necessary to monitor lipid parameters after this switch, despite the absence of an official recommendation.

Keywords: HIV, tenofovir alafenamide fumarate, tenofovir disoproxil fumarate, dyslipidemia, adverse events, hypolipidemic agents.

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Article Details

VOLUME: 19
ISSUE: 1
Year: 2021
Published on: 26 January, 2021
Page: [84 - 89]
Pages: 6
DOI: 10.2174/1570162X18666200824101838
Price: $65

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