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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 BeckWirth, Fabienne Bozon, Anne-Sophie Brunel, Marie-Christine Drobacheff-Thiebaut, Adeline Foltzer, Laurent Hustache-Mathieu, Jakub Kowalczyk, Catherine Michel, Siamak Davani and Patrice Muret   Pages 1 - 6 ( 6 )

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 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

Affiliation:

UBFC, Univ Bourgogne Franche-Comte, F-25000 Besancon, CHU Besancon, F-25000 Besancon, UBFC, Univ Bourgogne Franche-Comte, F-25000 Besancon, Internal Medicine Department, HIV-infection care center, GHR-Mulhouse Sud Alsace, Mulhouse, CHU Besancon, F-25000 Besancon, CHU Besancon, F-25000 Besancon, CHU Besancon, F-25000 Besancon, CHU Besancon, F-25000 Besancon, CHU Besancon, F-25000 Besancon, Internal Medicine Department, HIV-infection care center, GHR-Mulhouse Sud Alsace, Mulhouse, Internal Medicine Department, HIV-infection care center, GHR-Mulhouse Sud Alsace, Mulhouse, UBFC, Univ Bourgogne Franche-Comte, F-25000 Besancon, UBFC, Univ Bourgogne Franche-Comte, F-25000 Besancon



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