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

• Published in: Current HIV research Vol. 19; no. 1; p. 84
• Main Authors: Lagoutte-Renosi, Jennifer, Flammang, Mylène, Chirouze, Catherine, Beck-Wirth, Geneviève, Bozon, Fabienne, Brunel, Anne-Sophie, Drobacheff-Thiebaut, Marie-Christine, Foltzer, Adeline, Hustache-Mathieu, Laurent, Kowalczyk, Jakub, Michel, Catherine, Davani, Siamak, Muret, Patrice
• Format: Journal Article
• Language: English
• Published: Netherlands 01.01.2021
• Subjects: adverse events; tenofovir disoproxil fumarate; HIV; dyslipidemia; hypolipidemic agents; tenofovir alafenamide fumarate
• ISSN: 1873-4251
• DOI: 10.2174/1570162x18666200824101838

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. 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. 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. 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. 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.