Changes in cardiovascular and metabolic risk scores after switching to DOR/3TC/TDF, DTG/3TC or BIC/FTC/TAF: results from a multicenter Italian cohort.

OBJECTIVE

To assess changes of cardiovascular risk scores and metabolic scores after switching to DOR/3TC/TDF (DOR group), DTG/3TC (DTG group) or BIC/FTC/TAF (BIC group).

METHODS

We analyzed data from 1069 virologically suppressed people with HIV (PWH), collecting clinical history and laboratory parameters at baseline (date of switch) and 48 weeks of follow-up. In eligible PWH, we calculated body mass index (BMI), SCORE-2 for cardiovascular risk assessment and the metabolic score for insulin resistance (METS-IR) at both timepoints and performed linear mixed model for repeated measures to measure changes in parameters, while using linear regression analyses to search for predictors of change.

RESULTS

After 48 weeks, we observed significant changes in median SCORE-2 in all groups: there were increases of +0.12 in the DTG group ( P  = 0.021) and +0.30 in the BIC group (<0.001), while we observed a decrease of -0.35 in the DOR group ( P  < 0.001). In our regression analyses, taking DOR/3TC/TDF was a predictor of reduction of SCORE-2 compared with both DTG ( P  < 0.001) and BIC ( P  < 0.001).Regarding BMI, after 48 weeks we observed a median increase of +0.2 in BIC ( P  < 0.001), no changes in the DTG group and a median decrease of -0.04 in the DOR group ( P  < 0.001).Regarding METS-IR, after 48 weeks we observed a significant decrease in the DOR group (-0.9, P  = 0.024), while there were no significant changes with DTG and an increase of +0.3 with BIC ( P  = 0.013).

CONCLUSION

We found that switching to DOR/3TC/TDF was associated with more favorable changes in SCORE-2 and METS-IR compared to DTG/3TC and BIC/FTC/TAF.