Efficacy and Safety of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide as Maintenance Treatment in HIV/HBV-Coinfected Patients

doi:10.1097/QAI.0000000000002589

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Title:	Efficacy and Safety of Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide as Maintenance Treatment in HIV/HBV-Coinfected Patients
Authors:	Huang, Yu-Shan Cheng, Chien-Yu Liou, Bo-Huang Lu, Po-Liang Cheng, Shu-Hsing Lee, Yuan-Ti Liu, Chun-Eng Sun, Hsin-Yun Yang, Chia-Jui Tang, Hung-Jen Lin, Shih-Ping Ho, Mao-Wang Huang, Sung-Hsi Tsai, Hung-Chin Lee, Chen-Hsiang Hung, Chien-Ching
Contributors:	Natl Taiwan Univ Hosp, Dept Internal Med Natl Taiwan Univ, Coll Med Taoyuan Gen Hosp, Dept Infect Dis, Minist Hlth & Welf Natl Yang Ming Univ, Sch Publ Hlth Hsinchu MacKay Mem Hosp, Dept Internal Med Kaohsiung Med Univ Hosp, Dept Internal Med Kaohsiung Med Univ, Coll Med Taipei Med Univ, Sch Publ Hlth Chung Shan Med Univ Hosp, Dept Internal Med Chung Shan Med Univ, Sch Med Changhua Christian Hosp, Dept Internal Med Natl Yang Ming Univ, Sch Med Far Eastern Mem Hosp, Dept Internal Med Chi Mei Med Ctr, Dept Internal Med, Tainan, Taiwan;[Tang, Hung-Jen Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Taichung Vet Gen Hosp, Dept Internal Med China Med Univ Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med, Hsin Chu Branch Natl Taiwan Univ, Dept Trop Med & Parasitol, Coll Med Kaohsiung Vet Gen Hosp, Dept Internal Med Kaohsiung Chang Gung Mem Hosp, Dept Internal Med Chang Gung Univ, Coll Med
Keywords:	hepatitis B antiretroviral therapy proteinuria bone mineral density
Date:	2021
Issue Date:	2023-11-11 11:53:11 (UTC+8)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Abstract:	Background: The efficacy and safety of switching from tenofovir disoproxil fumarate-based antiretroviral therapy to coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (E/C/F/TAF) has not been widely investigated in HIV/hepatitis B virus (HBV)-coinfected Asian population. Methods: Between February and October 2018, HIV/HBV-coinfected patients who had achieved HIV viral suppression with tenofovir disoproxil fumarate-containing regimens were switched to E/C/F/TAF. Assessments of plasma HBV and HIV viral load, HBV serology, renal function, lipid profiles, and bone mineral density (BMD) were performed at weeks 24 and 48 after switch. Results: A total of 274 HIV/HBV-coinfected participants were enrolled, with 12.8% testing HBeAg-positive and 94.2% having plasma HBV DNA <20 IU/mL at baseline. At weeks 24 and 48, 92.7% and 89.8% achieved plasma HBV DNA <20 IU/mL; 4.7% and 5.1% had HBV DNA >= 20 IU/mL; and 2.6% and 5.1% had no data, respectively. At weeks 24 and 48, 95.6% and 94.2% of participants maintained HIV RNA <50 copies/mL, respectively. Compared with baseline, the median urine beta 2-microglobulin-to-creatinine ratio at week 48 decreased significantly from 165 to 90 mu g/g (P < 0.001). The mean BMD of the spine and hip improved at week 48 (+1.77% and +1.33%, respectively). Significantly higher lipid profiles were observed after switch to E/C/F/TAF. Thirteen (4.7%) patients withdrew from the study before week 48, with 7 (2.6%) patients because of adverse effects. Conclusions: Switch to E/C/F/TAF maintained HBV and HIV viral suppression and resulted in the improvement of proteinuria and BMD of the spine and hip but increased lipid levels in HIV/HBV-coinfected patients at week 48.
Relation:	JAIDS-J ACQ IMM DEF, v.86, n.4, pp.473-481
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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