To evaluate the evolution of weight and lipid profiles before and after switch to coformulated elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) among virally suppressed HIV-positive patients.
Between March and July 2018, patients switching to E/C/F/TAF were included. Weight, lipid profiles (triglyceride [TG], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and low-density lipoprotein cholesterol [LDL-C]), and glycated hemoglobin (HbA1C) 48 weeks before and after switch were analyzed using generalized estimating equation to identify the associated factors.
Of 693 patients included, weight gain was noted after switch at Weeks 12 (mean +0.63 kg), 24 (+1.25), 36 (+1.58), and 48 (+1.75) (all p < 0.0001). Weight change after switch was significantly greater than that observed within the preceding 48-week period before switch (+1.75 kg vs +0.54, p < 0.0001) and was correlated with switch to E/C/F/TAF (coefficient 0.29), later clinic visit (0.15), baseline weight (0.99), diabetes mellitus (coefficient -0.96), and age (-0.02) (all p < 0.01). At Week 48, significant increases were observed for TG (mean +62.93 mg/dl), TC (+22.30), LDL-C (+9.70), HDL-C (+3.65) (all p < 0.01) and HbA1C (+0.08%) (p < 0.05), but not TC/HDL-C ratio (+0.12, p = 0.38).
Virally suppressed HIV-positive patients gained a moderate amount of weight and had significant increases of lipid levels after switch to E/C/F/TAF.