Lipids Changes After Switch from TDF to TAF in the OPERA Cohort: LDL-cholesterol and Triglycerides
Abstract Background Increases in lipids have been observed in people living with HIV (PLWH) switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF). We assessed changes in low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) following a switch from TDF to TAF. Methods Adults with ≥1 lipid measure before and after switch from TDF-to-TAF were identified in the OPERA® cohort. Multivariable linear regression using generalized estimating equations were used to estimate predicted changes in lipids over time on TAF, modeled flexibly with linear splines. Results 6,451 PLWH switched from TDF-to-TAF, of whom 4,328 maintained all other agents. LDL-C increased significantly by 1.40 mg/dL/month over the first 3 months on TAF, by 0.33 mg/dL/month between 3-9 months and plateaued beyond 9 months. TG increased significantly by 3.52 mg/dL/month over the first 3 months of TAF, by 0.91 mg/mL/month between 3-9 months, and by 0.72 mg/mL/month between 9-16 months but decreased thereafter. Similar patterns were observed in analyses restricted to PLWH who switched from TDF-to-TAF but maintained all other agents. Discussion TDF-to-TAF switch was associated with LDL-C and TG increases over the first 9 to 16 months on TAF. The dynamic patterns observed cannot be attributed to changes in other agents.