Objective: To evaluate the lipid profile and body mass index (BMI) in antiretroviral-experienced people living with HIV (PLWH) starting therapy with two doravirine (DOR)-based regimens (dolutegravir (DTG)/DOR or lamivudine (3TC)/tenofovir disoproxil fumarate (TDF)/DOR). Methods: Data from the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective database, including all experienced PLWH who started treatment with DTG/DOR and 3TC/TDF/DOR. To obtain a comparable sample, subjects on emtricitabine (FTC)/tenofovir alafenamide (TAF)/bictegravir (BIC) were matched 1:1 (by sex, age (±1 year), at least one between dyslipidemia and statin use) with those on 3TC/TDF/DOR. Results: Among 355 PLWH on viral suppression, the median age was 53 years; men represented 74.9% of the sample. At baseline, 147 people treated with FTC/TAF/BIC had a better lipid profile and lower CD4 cell count than 147 people treated with 3TC/TDF/DOR; diabetes was less frequent in the latter group. After 6 and 12 months, the BMI did not significantly change in any of the groups. Total cholesterol (TC) level significantly declined in PLWH on 3TC/TDF/DOR but not in FTC/TAF/BIC and remained unchanged in DTG/DOR. LDL-C showed a similar trend, with the most marked decline in the 3TC/TDF/DOR group and no difference in FTC/TAF/BIC. The TC/HDL-C ratio declined significantly in 3TC/TDF/DOR and DTG/DOR but not in FTC/TAF/BIC. Over the entire observation period (median 18 months, interquartile range 10–30), 43 (12.1%) PLWH interrupted the cohort drug, mainly because of adverse events (n = 15), with 12 lost to follow-up and 12 simplifications. Conclusions: The regimens were well tolerated in terms of lipid profile and BMI. Persons treated with 3TC/TDF/DOR triple regimen showed a better lipid profile, as expected, whereas those on DTG/DOR did not show any significant changes.
Maggi, P., Masiello, A., Menzaghi, B., Sarchi, E., Bellagamba, R., Pellicanò, G.F., et al. (2025). Lipids and Body Mass Index in Antiretroviral‐Experienced People With HIV on Doravirine‐Based Treatments: A Comparison Between Dual or Triple Regimen Versus Bictegravir‐Based Triple Regimen. AIDS RESEARCH AND TREATMENT, 2025(1) [10.1155/arat/2040298].
Lipids and Body Mass Index in Antiretroviral‐Experienced People With HIV on Doravirine‐Based Treatments: A Comparison Between Dual or Triple Regimen Versus Bictegravir‐Based Triple Regimen
Cascio, Antonio;
2025-01-01
Abstract
Objective: To evaluate the lipid profile and body mass index (BMI) in antiretroviral-experienced people living with HIV (PLWH) starting therapy with two doravirine (DOR)-based regimens (dolutegravir (DTG)/DOR or lamivudine (3TC)/tenofovir disoproxil fumarate (TDF)/DOR). Methods: Data from the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective database, including all experienced PLWH who started treatment with DTG/DOR and 3TC/TDF/DOR. To obtain a comparable sample, subjects on emtricitabine (FTC)/tenofovir alafenamide (TAF)/bictegravir (BIC) were matched 1:1 (by sex, age (±1 year), at least one between dyslipidemia and statin use) with those on 3TC/TDF/DOR. Results: Among 355 PLWH on viral suppression, the median age was 53 years; men represented 74.9% of the sample. At baseline, 147 people treated with FTC/TAF/BIC had a better lipid profile and lower CD4 cell count than 147 people treated with 3TC/TDF/DOR; diabetes was less frequent in the latter group. After 6 and 12 months, the BMI did not significantly change in any of the groups. Total cholesterol (TC) level significantly declined in PLWH on 3TC/TDF/DOR but not in FTC/TAF/BIC and remained unchanged in DTG/DOR. LDL-C showed a similar trend, with the most marked decline in the 3TC/TDF/DOR group and no difference in FTC/TAF/BIC. The TC/HDL-C ratio declined significantly in 3TC/TDF/DOR and DTG/DOR but not in FTC/TAF/BIC. Over the entire observation period (median 18 months, interquartile range 10–30), 43 (12.1%) PLWH interrupted the cohort drug, mainly because of adverse events (n = 15), with 12 lost to follow-up and 12 simplifications. Conclusions: The regimens were well tolerated in terms of lipid profile and BMI. Persons treated with 3TC/TDF/DOR triple regimen showed a better lipid profile, as expected, whereas those on DTG/DOR did not show any significant changes.
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