eGFR-EPI changes among HIV patients who switch from F/TDF to F/TAF while maintaining the same third agent in the Spanish VACH cohort

Identificador:  imarina:9226943

Handle: https://hdl.handle.net/20.500.11797/imarina9226943

Autors:  Teira, Ramon; Diaz-Cuervo, Helena; Aragao, Filipa; Munoz, Josefa; Galindo, Pepa; Merino, MariaDolores; de la Fuente, Belen; Sepulveda, Maria Antonia; Domingo, Pere; Garcia, Josefina; Castano, Manuel; Ribera, Esteve; Geijo, Paloma; Romero, Alberto; Peraire, Joaquim; Deig, Elisabeth; Roca, Bernardino; Martinez, Elisa; Estrada, Vicente; Montero, Marta; Berenguer, Juan; Espinosa, Nuria

Resum:
Background: Evidence from clinical practice on the effects of switching from emtricitabine/tenofovir disoproxil fumarate (F/TDF) to emtricitabine/tenofovir alafenamide (F/TAF)-based triple-therapy (TT) regimens on renal parameters is limited. Objective: This retrospective analysis evaluated the effects on renal function of switching from F/TDF to F/TAF-based TT regimens with no change in third agent among people living with HIV (PLWH). Methods: Data were from a multicenter Spanish PLWH cohort. Patients with a baseline estimated glomerular filtration rate (eGFR-EPI) measurement, >= 1 follow-up measurement, >= 30 days treatment with F/TAF, and who switched from F/TDF to F/TAF with no change in third agent were included. Multivariate mixed linear models were used to evaluate change from baseline over time in eGFR-EPI. eGFR-EPI changes before and after switch were analyzed in a matched patient subgroup. Results: Overall, 340 patients were included. Mean (95% CI) eGFR-EPI in patients with baseline eGFR-EPI <90 ml/min/1.73m(2) (n = 125) was 79.6 (78.0; 81.2) ml/min/1.73m(2) at baseline and 81.3 (79.9; 82.7) ml/min/1.73m(2) at 12 months after switch. In the patient-matched subgroup (n = 175), median annual eGFR-EPI declined -4.24 ml/min/1.73m(2) while on F/TDF and increased +0.93 ml/min/1.73m(2) after switch to F/TAF (P < 0.0001). In patients with baseline eGFR-EPI <90 ml/min/1.73m(2), median annual eGFR-EPI increased +4.19 mL/min/1.73m(2) after switch (P < 0.0001). Conclusion: Switching from F/TDF to F/TAF-based TT regimens while maintaining the same third agent numerically improved eGFR-EPI in PLWH with baseline eGFR-EPI <90 mL/min/1.73m(2). eGFR-EPI improved significantly when comparing progression while on F/TDF vs progression after switch, confirming beneficial renal effects of switching to F/TAF in a clinical practice setting.