Week 96 Results of Switching from Tenofovir Disoproxil Fumarate-Based Antiretroviral Therapy to Coformulated Elvitegravir, Cobicistat, Emtricitabine, and Tenofovir Alafenamide among HIV/Hepatitis B Virus-Coinfected Patients.

Autor:	Huang YS; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Cheng CY; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.; School of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan., Sun HY; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Cheng SH; Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.; School of Public Health, Taipei Medical University, Taipei, Taiwan., Lu PL; Department of Internal Medicine, Kaohsiung Medical University and College of Medicine, Kaohsiung, Taiwan., Lee CH; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan., Lee YT; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.; School of Medicine, Chung Shan Medical University, Taichung, Taiwan., Tsai HC; Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan., Yang CJ; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan., Liu CE; Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan., Liou BH; Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan., Lin SP; Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan., Huang SH; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan., Ho MW; Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan., Tang HJ; Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.; Department of Health and Nutrition, Chia Nan University of Pharmacy and Sciences, Tainan, Taiwan., Hung CC; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
Jazyk:	angličtina
Zdroj:	Microbiology spectrum [Microbiol Spectr] 2023 Jun 15; Vol. 11 (3), pp. e0512522. Date of Electronic Publication: 2023 Mar 29.
DOI:	10.1128/spectrum.05125-22
Abstrakt:	Data regarding the durability of tenofovir alafenamide (TAF)-containing antiretroviral therapy (ART) in maintaining hepatitis B virus (HBV) viral suppression among HIV/HBV-coinfected patients are limited. Between February and October 2018, 274 HIV/HBV-coinfected participants who had achieved HIV RNA of <50 copies/mL with tenofovir disoproxil fumarate (TDF)-containing ART and switched to elvitegravir/cobicistat/emtricitabine/TAF were prospectively enrolled. Serial plasma HIV and HBV viral loads, HBV and hepatitis D virus (HDV) serology, renal parameters, metabolic profiles, and bone mineral density (BMD) were assessed through 96 weeks. At baseline and weeks 48, 72, and 96, 5.8%, 5.1%, 5.8%, and 5.1% of the participants had plasma HBV DNA of ≥20 IU/mL, and 0%, 0.7%, 1.5%, and 2.2% had HIV RNA of ≥50 copies/mL, respectively. Hepatitis B surface antigen (HBsAg) loss occurred in 1.5% of 274 participants, and hepatitis B e-antigen (HBeAg) loss or seroconversion occurred in 14.3% of 35 HBeAg-positive participants. Compared with baseline, the median urine protein-to-creatinine ratio (79 versus 63 mg/g, P  < 0.001) and β2-microglobulin-to-creatinine ratio (165 versus 83 μg/g, P  < 0.001) continued to decrease at week 96. BMD of the spine and hip slightly increased (mean change, +0.9% and +0.5%, respectively). The median triglycerides, total cholesterol, low-density lipoprotein (LDL)-cholesterol and high-density lipoprotein (HDL)-cholesterol increased from baseline to week 96 (116 versus 141, 166 versus 190, 99 versus 117, and 42 versus 47 mg/dL, respectively; all P  < 0.001), and most of the increases occurred in the first 48 weeks of the switch. Our study showed that switching from TDF-containing ART to elvitegravir/cobicistat/emtricitabine/TAF maintained HBV and HIV viral suppression through 96 weeks among HIV/HBV-coinfected patients. Proteinuria continued to improve, while fasting lipids increased and BMD stabilized at 96 weeks after the switch. IMPORTANCE Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide as a maintenance therapy showed durable and high rates of viral suppression for HIV/HBV-coinfected patients, with only 5.1% and 2.2% of patients having HBV DNA of ≥20 IU/mL and HIV RNA of ≥50 copies/mL, respectively, at 96 weeks. Our study fills the data gap on the long-term clinical effectiveness of tenofovir alafenamide-containing antiretroviral therapy in people living with HIV who have HBV coinfection. Competing Interests: The authors declare a conflict of interest. Chien-Ching Hung has received research support from Gilead Sciences, Merck, and ViiV and speaker honoraria from Gilead Sciences and ViiV, and served on advisory boards for Gilead Sciences and ViiV. Hsin-Yun Sun has received research support from Gilead Sciences. Other authors report no conflicts of interest.
Databáze:	MEDLINE
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