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

doi:10.1128/spectrum.05125-22

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Title:	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
Authors:	Huang, Yu-Shan Cheng, Chien-Yu Sun, Hsin-Yun Cheng, Shu-Hsing Lu, Po-Liang Lee, Chen-Hsiang Lee, Yuan-Ti Tsai, Hung-Chin Yang, Chia-Jui Liu, Chun-Eng Liou, Bo-Huang Lin, Shih-Ping Huang, Sung-Hsi Ho, Mao-Wang Tang, Hung-Jen 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 Chiao Tung Univ, Sch Publ Hlth Taipei Med Univ, Sch Publ Hlth Kaohsiung Med Univ & Coll Med, Dept Internal Med Kaohsiung Chang Gung Mem Hosp, Dept Internal Med Chang Gung Univ, Coll Med Chung Shan Med Univ Hosp, Dept Internal Med Chung Shan Med Univ, Sch Med Kaohsiung Vet Gen Hosp, Dept Internal Med Natl Yang Ming Chiao Tung Univ, Sch Med Far Eastern Mem Hosp, Dept Internal Med Changhua Christian Hosp, Dept Internal Med Hsinchu MacKay Mem Hosp, Dept Internal Med Taichung Vet Gen Hosp, Dept Internal Med Natl Taiwan Univ Hosp, Dept Internal Med, Hsinchu Branch Natl Taiwan Univ, Dept Trop Med & Parasitol, Coll Med China Med Univ Hosp, Dept Internal Med Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Natl Taiwan Univ Hosp, Dept Internal Med
Keywords:	viral hepatitis antiretroviral therapy bone mineral density hepatitis D virus hyperlipidemia proximal renal tubulopathy tenofovir
Date:	2023
Issue Date:	2024-12-25 11:05:51 (UTC+8)
Publisher:	AMER SOC MICROBIOLOGY
Abstract:	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 beta 2-microglobulin-to-creatinine ratio (165 versus 83 mu g/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. 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.
Relation:	Microbiology Spectrum, v.11, n.3
Appears in Collections:	[Offices] 456

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