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Abstract：
BACKGROUND: We aimed to assess the overall cardiovascular and metabolic effect of the switch to three different single tablet regimens (STRs) [tenofovir alafenamide/emtricitabine/rilpivirine (TAF/FTC/RPV), TAF/FTC/elvitegravir/cobi (TAF/FTC/EVG/cobi) and ABC/lamivudine/dolutegravir (ABC/3TC/DTG)] in a cohort of people living with HIV/AIDS (PLWH) under effective ART.
METHODS: All PLWH aged above 18 years on antiretroviral treatment with an HIV-RNA < 50 cp/mL at the time of the switch to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG were retrospectively included in the analysis. Framingham risk score modification after 12 months from the switch such as lipid profile and body weight modification were assessed. The change from baseline to 12 months in mean cardiovascular risk and body weight in each of the STR\'s group were assessed by means of Wilcoxon signed-rank test whereas a mixed regression model was used to assess variation in lipid levels.
RESULTS: Five-hundred and sixty PLWH were switched to an STR regimen of whom 170 (30.4%) to TAF/FTC/EVG/cobi, 191 (34.1%) to TAF/FTC/RPV and 199 (35.5%) to ABC/3TC/DTG. No difference in the Framingham cardiovascular risk score was observed after 12 months from the switch in each of the STR\'s groups. No significant overtime variation in mean total cholesterol levels from baseline to 12 months was observed for PLWH switched to ABC/3TC/DTG [200 (SD 38) mg/dl vs 201 (SD 35) mg/dl; p = 0.610] whereas a significant increment was observed in PLWH switched to TAF/FTC/EVG/cobi [192 (SD 34) mg/dl vs 208 (SD 40) mg/dl; p < 0.0001] and TAF/FTC/RPV [187 (SD 34) mg/dl vs 195 (SD 35) mg/dl; p = 0.027]. In addition, a significant variation in the mean body weight from baseline to 12 months was observed in PLWH switched to TAF/FTC/EVG/cobi [72.2 (SD 13.5) kilograms vs 74.6 (SD 14.3) kilograms; p < 0.0001] and TAF/FTC/RPV [73.4 (SD 11.6) kilograms vs 75.6 (SD 11.8) kilograms; p < 0.0001] whereas no difference was observed in those switched to ABC/3TC/DTG [71.5 (SD 12.8) kilograms vs 72.1 (SD 12.6) kilograms; p = 0.478].
CONCLUSIONS: No difference in the cardiovascular risk after 1 year from the switch to these STRs were observed. PLWH switched to TAF/FTC/EVG/cobi and TAF/FTC/RPV showed an increase in total cholesterol levels and body weight 12 months after the switch.
METHODS: All PLWH aged above 18 years on antiretroviral treatment with an HIV-RNA < 50 cp/mL at the time of the switch to TAF/FTC/RPV, TAF/FTC/EVG/cobi and ABC/3TC/DTG were retrospectively included in the analysis. Framingham risk score modification after 12 months from the switch such as lipid profile and body weight modification were assessed. The change from baseline to 12 months in mean cardiovascular risk and body weight in each of the STR\'s group were assessed by means of Wilcoxon signed-rank test whereas a mixed regression model was used to assess variation in lipid levels.
RESULTS: Five-hundred and sixty PLWH were switched to an STR regimen of whom 170 (30.4%) to TAF/FTC/EVG/cobi, 191 (34.1%) to TAF/FTC/RPV and 199 (35.5%) to ABC/3TC/DTG. No difference in the Framingham cardiovascular risk score was observed after 12 months from the switch in each of the STR\'s groups. No significant overtime variation in mean total cholesterol levels from baseline to 12 months was observed for PLWH switched to ABC/3TC/DTG [200 (SD 38) mg/dl vs 201 (SD 35) mg/dl; p = 0.610] whereas a significant increment was observed in PLWH switched to TAF/FTC/EVG/cobi [192 (SD 34) mg/dl vs 208 (SD 40) mg/dl; p < 0.0001] and TAF/FTC/RPV [187 (SD 34) mg/dl vs 195 (SD 35) mg/dl; p = 0.027]. In addition, a significant variation in the mean body weight from baseline to 12 months was observed in PLWH switched to TAF/FTC/EVG/cobi [72.2 (SD 13.5) kilograms vs 74.6 (SD 14.3) kilograms; p < 0.0001] and TAF/FTC/RPV [73.4 (SD 11.6) kilograms vs 75.6 (SD 11.8) kilograms; p < 0.0001] whereas no difference was observed in those switched to ABC/3TC/DTG [71.5 (SD 12.8) kilograms vs 72.1 (SD 12.6) kilograms; p = 0.478].
CONCLUSIONS: No difference in the cardiovascular risk after 1 year from the switch to these STRs were observed. PLWH switched to TAF/FTC/EVG/cobi and TAF/FTC/RPV showed an increase in total cholesterol levels and body weight 12 months after the switch.
摘要：
背景：我们旨在评估转换为三种不同的单片治疗方案（STRs）[替诺福韦艾拉酚胺/恩曲他滨/利匹韦林（TAF/FTC/RPV）的总体心血管和代谢作用，TAF/FTC/elvitegravir/cobi（TAF/FTC/EVG/cobi）和ABC/拉米夫定/dolutegravir（ABC/3TC/DTG）]在有效的ART下的HIV/AIDS患者队列中。
方法：所有18岁以上的PLWH在转换为TAF/FTC/RPV时接受HIV-RNA<50cp/mL的抗逆转录病毒治疗，回顾性分析包括TAF/FTC/EVG/cobi和ABC/3TC/DTG。评估了12个月后的Framingham风险评分变化，例如血脂和体重变化。通过Wilcoxon符号秩检验评估每个STR组的平均心血管风险和体重从基线到12个月的变化，而混合回归模型用于评估血脂水平的变化。
结果：将五百六十个PLWH转换为STR方案，其中170（30.4％）转换为TAF/FTC/EVG/cobi，TAF/FTC/RPV为191（34.1%），ABC/3TC/DTG为199（35.5%）。在每个STR组的转换后12个月，Framingham心血管风险评分没有差异。从基线到12个月，PLWH转换为ABC/3TC/DTG[200（SD38）mg/dlvs201（SD35）mg/dl；p=0.610]，而在PLWH转换为TAF/FTC/EVG/cobi中观察到显着增加[192（SD34）mg/dlvs208（SD40）mg/dlPV27；p<0.00F34]和此外,在PLWH转换为TAF/FTC/EVG/cobi[72.2（SD13.5）千克vs74.6（SD14.3）千克;p<0.0001]和TAF/FTC/RPV[73.4（SD11.6）千克vs75.6（SD11.8）千克;p<0.0001]转换为[SD/12.8]的那些没有差异。
结论：转用这些STRs后1年心血管风险无差异。PLWH切换到TAF/FTC/EVG/cobi和TAF/FTC/RPV显示总胆固醇水平和体重在切换后12个月增加。
方法：所有18岁以上的PLWH在转换为TAF/FTC/RPV时接受HIV-RNA<50cp/mL的抗逆转录病毒治疗，回顾性分析包括TAF/FTC/EVG/cobi和ABC/3TC/DTG。评估了12个月后的Framingham风险评分变化，例如血脂和体重变化。通过Wilcoxon符号秩检验评估每个STR组的平均心血管风险和体重从基线到12个月的变化，而混合回归模型用于评估血脂水平的变化。
结果：将五百六十个PLWH转换为STR方案，其中170（30.4％）转换为TAF/FTC/EVG/cobi，TAF/FTC/RPV为191（34.1%），ABC/3TC/DTG为199（35.5%）。在每个STR组的转换后12个月，Framingham心血管风险评分没有差异。从基线到12个月，PLWH转换为ABC/3TC/DTG[200（SD38）mg/dlvs201（SD35）mg/dl；p=0.610]，而在PLWH转换为TAF/FTC/EVG/cobi中观察到显着增加[192（SD34）mg/dlvs208（SD40）mg/dlPV27；p<0.00F34]和此外,在PLWH转换为TAF/FTC/EVG/cobi[72.2（SD13.5）千克vs74.6（SD14.3）千克;p<0.0001]和TAF/FTC/RPV[73.4（SD11.6）千克vs75.6（SD11.8）千克;p<0.0001]转换为[SD/12.8]的那些没有差异。
结论：转用这些STRs后1年心血管风险无差异。PLWH切换到TAF/FTC/EVG/cobi和TAF/FTC/RPV显示总胆固醇水平和体重在切换后12个月增加。
