Impact of Combination Antiretroviral Treatment on Liver Metabolic Health in HIV-Infected Persons

Biały, Michał; Czarnecki, Marcin; Inglot, Małgorzata

doi:10.3390/v15122432

Cited by 3 publications

(3 citation statements)

References 65 publications

(116 reference statements)

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“…However, one year after starting the treatment, significant differences are observed in the increase in transaminases and ALP. Through these results, we reinforce the findings of other studies [ 20 , 21 , 22 ] that demonstrate that the new generation therapy affects liver function less than the older generation therapy.…”

Section: Discussionsupporting

confidence: 90%

Evaluating Hepatotoxicity: A Comparative Analysis of New Generation versus Historical Antiretroviral Agents

Abu-Awwad,

Suba

et al. 2024

Infectious Disease Reports

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(1) Background: Since the advent of zidovudine in 1987, antiretroviral therapy has undergone significant evolution, marked by the introduction of 34 antiretroviral drugs and 24 fixed-dose combinations. Despite these advances, hepatotoxicity remains a formidable challenge, influencing morbidity, mortality, and treatment adherence in HIV-infected patients. This study aims to compare the hepatotoxic effects of latest-generation antiretroviral medications with those of older-generation therapies, assessing their long-term impact on liver health in HIV patients. (2) Methods: This retrospective study analyzed data from 304 HIV patients treated with either latest-generation or older-generation antiretroviral drugs over four years. Patients were monitored for hepatotoxicity through liver function tests at diagnosis, six months, and one-year post-treatment initiation. (3) Results: Initial and six-month liver function tests showed no significant differences between the two groups. However, at one-year post-treatment, patients on latest-generation antiretrovirals exhibited significant improvements in ALT, AST, and ALP levels, suggesting a better safety profile regarding hepatotoxicity. Additionally, a significantly lower incidence of splenomegaly was observed in patients treated with newer medications. (4) Conclusions: The findings suggest that the latest-generation antiretroviral medications may offer a safer profile in terms of hepatotoxicity compared to older therapies, with potential benefits for long-term liver health. This study underscores the importance of continuous monitoring and further research to optimize ART strategies, ensuring improved patient outcomes and quality of life for individuals living with HIV.

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Section: Discussionsupporting

confidence: 90%

Evaluating Hepatotoxicity: A Comparative Analysis of New Generation versus Historical Antiretroviral Agents

Abu-Awwad,

Suba

et al. 2024

Infectious Disease Reports

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“…Our research observed that lipid pro le deterioration was particularly pronounced in measurements taken within the rst 24 months. The study's subgroup analyses showed that TAF and BIC therapies had the most detrimental impact on cholesterol levels [33]. Our study also indicates that lipid deterioration was particularly pronounced in measurements taken within the rst 24 months.…”

Section: Discussionsupporting

confidence: 49%

“…Our study also indicates that lipid deterioration was particularly pronounced in measurements taken within the rst 24 months. Another study highlighted that over the years, switching from TDF to TAF and especially using INSTI combinations could lead to a cascade of metabolic disorders, including metabolic syndrome, fatty liver, and eventually insulin resistance [34]. The elevation in ALT observed in cases using TAF-based combinations could be associated with hepatosteatosis.…”

Section: Discussionmentioning

confidence: 99%

Comparative Metabolic Effects of Integrase Inhibitor and Emtricitabine-Containing Tenofovir Derivatives in People Living with HIV: A Multi-Center Retrospective Analysis

Karabay,

Vatan,

Yılmaz

et al. 2024

Preprint

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Background This retrospective, multi-center cohort study aimed to compare the effects of Integrase Strand Transfer Inhibitor (INSTI) based therapies containing tenofovir disoproxil fumarate (TDF)/ Emstristabin (FTC) /Dolutegravir (DTG), TDF/FTC/Cobicistat (C)/Elvitegravir(EVG), TDF/FTC/Raltegravir (RAL) and tenofovir alafenamide (TAF)/FTC/Bictegravir (BIC), TAF/FTC/c/EVG) combinations on bone metabolism, lipid profile, and renal function in people living with HIV (PLWH). Methods Adults aged ≥ 18 years receiving antiretroviral therapy (ART) for ≥ 12 months were followed for ≥ 24 months. Data were obtained from HIV/AIDS clinic records and hospital databases, including demographics, laboratory values (HIV RNA, CD4 + T lymphocyte count, creatinine, eGFR, ALT), lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides), and DEXA results. Statistical significance was defined as a p-value less than 0.05. Findings: The treatment outcomes of 901 HIV-infected individuals from 9 centers in Türkiye were evaluated. After applying exclusion criteria, data from 845 individuals were included: 462 in the TDF group (mean age 43.25 ± 12.35) and 383 in the TAF group (mean age 41.75 ± 12.08) (p = 0.082). The proportion of female patients was 18.4% in the TDF group and 13.6% in the TAF group (p = 0.058). In the TDF group, 77.2% were treatment-naïve, compared to 52.2% in the TAF group (p < 0.001). At 24 months, HIV RNA levels were 14218.43 ± 233947.64 IU/ml in the TDF group and 3247.15 ± 55371.53 IU/ml in the TAF group (p < 0.001). Although CD4 levels were higher at baseline in the TAF group (p < 0.001), the TDF group showed a greater increase at 48 months (p = 0.013). ALT normalization was better in the TDF group, while total and non-HDL cholesterol levels were higher in the TAF group. Conclusion TDF and TAF-containing INSTI-based regimens exhibit distinct impacts on lipid profiles and immune function in PLWH. The early advantages of TAF in viral load reduction diminish over time, contrasting with the long-term benefits of TDF in terms of CD4 counts, ALT levels, and non-HDL cholesterol. These findings highlight the necessity of individualized treatment in selecting ART regimens.

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Hepatic Toxicity Assessment in HIV’s Interaction with Reverse Transcriptase and Integrase Strand Transfer Inhibitors at a Military Hospital, Southsouth Nigeria

Odegbemi,

Olaniyan,

Muhibi

2024

Preprint

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Anti-retroviral therapy (ART) use has made HIV a manageable condition, but there are risks associated with medications like Reverse Transcriptase Inhibitors (RTIs) and Integrase Strand Transfer Inhibitors (INSTIs), such as liver and renal toxicity. It is essential to understand these risks for effective treatment. Investigating liver toxicity related to RTIs and INSTIs in Nigeria is crucial for optimizing HIV treatment. This study aimed to assess the impact of Tenofovir Lamivudine Dolutegravir (TLD) on the liver function of HIV-patients at Nigerian Navy Hospital (NNH) Warri. Liver function of 170 participants was assessed, with 120 on ART and the remainder being HIV-negative attendees at NNH Warri. The study used a cross-sectional design and selected participants through simple random sampling. We collected data using semi-structured questionnaire. Blood samples were taken through venipuncture and stored at -20oC before analysis. Ethical approval was obtained, and data analysis was conducted using SPSS Statistical Software, with significance set at p < 0.05. The study found significant differences in AST, TP, Alb, and GST levels between HIV-positive subjects receiving TLD and HIV-negative individuals. HIV-positive subjects had lower AST and Alb levels but higher TP and GST levels. Further analysis revealed correlations between age, gender, and liver enzymes, highlighting the complex relationship between HIV, liver function, and treatment outcomes. The study suggests that decreased AST levels may have a protective effect, while ALT activity had minimal impact. Changes in TP, Alb, and GSTs emphasize the importance of monitoring hepatic synthetic function and detoxification pathways in HIV patients taking TLD.

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Impact of Combination Antiretroviral Treatment on Liver Metabolic Health in HIV-Infected Persons

Cited by 3 publications

References 65 publications

Evaluating Hepatotoxicity: A Comparative Analysis of New Generation versus Historical Antiretroviral Agents

Evaluating Hepatotoxicity: A Comparative Analysis of New Generation versus Historical Antiretroviral Agents

Comparative Metabolic Effects of Integrase Inhibitor and Emtricitabine-Containing Tenofovir Derivatives in People Living with HIV: A Multi-Center Retrospective Analysis

Hepatic Toxicity Assessment in HIV’s Interaction with Reverse Transcriptase and Integrase Strand Transfer Inhibitors at a Military Hospital, Southsouth Nigeria

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