Tenofovir Disoproxil to Tenofovir Alafenamide Switching Impact, Real-life Experience

Abstract

Abstract

Background: The NHS policy limits Tenofovir Alafenamide (TAF) to renally or bone damaged patients due to its favourable effects on bone and kidneys compared to Tenofovir Disoproxil (TDF). This study aimed to assess healthcare providers' adherence (HCPs) to the NHS policy and the impact of switching to TAF on various health indicators, including viral load, renal functions, weight, and lipid profile.

Methods: This retrospective study included HIV patients aged ≥ 18 years who were on TAF (Descovy) between January and December 2022 and switched from TDF to TAF. HCP adherence was assessed by reviewing hospital documentation. The health indicators were the biochemistry tests obtained from hospital laboratory results. ANOVA and Non-parametric tests were used to compare the results at baseline, 6 months and 12 months.

Results: The study included 79 patients. The HCP's adherence to the NHS policy was 62% (49/79). 12-month post-switch TAF impact was only significant for five variables. The mean serum creatinine (sCr) decreased from 101 to 93 μmol/L. The mean rank eGFR decreased from 2.38 to 1.81 in patients with stage G3a baseline. The mean rank urine albumin creatinine ratio (UACR) decreased from 2.25 to 1.84. The median weight increased from 78 to 79 kg. The mean total cholesterol (TC) increased from 4.75 to 5.22 mmol/L.

Conclusion: The HCPs' low adherence rate highlights the need to increase their awareness of the NHS policy. TAF improves renal function by improving patients’ sCr, UACR, and eGFR stage G3a. However, it increases weight and TC.