Rates and predictors of switching to tenofovir alafenamide-containing ART in a nationwide cohort.

Details

Serval ID
serval:BIB_33535700F126
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Rates and predictors of switching to tenofovir alafenamide-containing ART in a nationwide cohort.
Journal
BMC infectious diseases
Author(s)
Surial B., Cavassini M., Calmy A., Fehr J., Stöckle M., Bernasconi E., Roth B., Fux C.A., Kovari H., Furrer H., Rauch A., Wandeler G.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Anagnostopoulos A., Battegay M., Bernasconi E., Böni J., Braun D.L., Bucher H.C., Calmy A., Cavassini M., Ciuffi A., Dollenmaier G., Egger M., Elzi L., Fehr J., Fellay J., Furrer H., Fux C.A., Günthard H.F., Haerry D., Hasse B., Hirsch H.H., Hoffmann M., Hösli I., Huber M., Kahlert C.R., Kaiser L., Keiser O., Klimkait T., Kouyos R.D., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Marzolini C., Metzner K.J., Müller N., Nicca D., Paioni P., Pantaleo G., Perreau M., Rauch A., Rudin C., Scherrer A.U., Schmid P., Speck R., Stöckle M., Tarr P., Trkola A., Vernazza P., Wandeler G., Weber R., Yerly S.
ISSN
1471-2334 (Electronic)
ISSN-L
1471-2334
Publication state
Published
Issued date
10/10/2019
Peer-reviewed
Oui
Volume
19
Number
1
Pages
834
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Tenofovir alafenamide (TAF)-containing combinations were introduced in Switzerland after October 2016 and are recommended over tenofovir disoproxil fumarate (TDF) in patients with osteoporosis or impaired renal function.
We included all participants of the Swiss HIV Cohort Study on TDF-containing antiretroviral therapy with follow-up visits after January 2016. We determined the proportion of switches from TDF to TAF overall, and among patients with risk factors for TDF toxicity, including osteoporosis, impaired renal function or marked proteinuria. We used multivariable logistic regression to explore predictors of switching from TDF to TAF.
We included 5'012 patients, of whom 652 (13.0%) had risk factors for TDF toxicity. A switch from TDF to TAF was undertaken in 2'796 (55.8%) individuals overall, and in 465 (71.3%) with risk factors. Predictors of switching to TAF were male sex (adjusted odds ratio 1.27, 95% confidence interval 1.07-1.50), age > 50 years (1.43, 1.23-1.66) and the presence of risk factors for TDF toxicity (2.21, 1.77-2.75). In contrast, patients with a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based single-pill regimen (0.11, 0.09-0.13), those treated in non-tertiary care centers (0.56, 0.46-0.70), as well as those with CD4 cell counts below 500/μL (0.77, 0.66-0.90) and with chronic hepatitis C infection (0.66, 0.54-0.80) were most likely to stay on TDF.
Over 50% of patients on TDF-containing therapy, including the majority of patients at risk for TDF toxicity, were switched to TAF within two years of its introduction in Switzerland. Individuals on NNRTI-based single-pill regimens were most likely to remain on TDF.
Keywords
Adenine/analogs & derivatives, Adenine/therapeutic use, Adult, Anti-HIV Agents/therapeutic use, CD4 Lymphocyte Count, Cohort Studies, Drug Interactions, Female, HIV Infections/complications, HIV Infections/drug therapy, Hepatitis C, Chronic/complications, Hepatitis C, Chronic/pathology, Humans, Male, Middle Aged, Risk Factors, Switzerland, Tenofovir/adverse effects, Tenofovir/therapeutic use, Antiretroviral therapy, Switch, Tenofovir alafenamide, Tenofovir disoproxil fumarate, Toxicity
Pubmed
Web of science
Open Access
Yes
Create date
13/10/2019 18:47
Last modification date
28/01/2020 6:26
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