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Switching from a regimen containing abacavir/lamivudine or emtricitabine/tenofovir disoproxil fumarate to emtricitabine/tenofovir alafenamide fumarate does not affect central nervous system HIV-1 infection.
Infect Dis (Lond) 2019 Nov - Dec; 51(11-12):838-846ID

Abstract

Background:

Despite suppressive antiretroviral therapy (ART), many HIV-infected individuals have low-level persistent immune activation in the central nervous system (CNS). There have been concerns regarding the CNS efficacy of tenofovir alafenamide fumarate (TAF) because of its low cerebrospinal fluid (CSF) concentrations and because it is a substrate of the active efflux transporter P-glycoprotein. Our aim was to investigate whether switching from emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) or abacavir (ABC)/lamivudine (3TC) to FTC/TAF would lead to changes in residual intrathecal immune activation, viral load, or neurocognitive function.

Methods:

Twenty HIV-1-infected neuro-asymptomatic adults (11 on ABC/3TC and 9 on FTC/TDF) were included in this prospective study. At baseline, all participants changed their nucleoside analogues to FTC/TAF without any other changes in their ART regimen. We performed lumbar punctures, venipunctures, and neurocognitive testing at baseline and after three and 12 months.

Results:

During follow-up, there were no significant changes in CSF or plasma HIV RNA, CSF neopterin, CSF β2-microglobulin, IgG index, albumin ratio, CSF NFL, or neurocognitive function in assessed by Cogstate in any of the groups.

Conclusion:

This small pilot study indicates that switching to FTC/TAF from ABC/3TC or FTC/TDF has neither a positive, nor a negative effect on the HIV infection in the CNS.

Authors+Show Affiliations

Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden. Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital , Gothenburg, Sweden.Clinic of Infectious Diseases, Södra Älvsborg Hospital , Borås , Sweden.Division of Biological Chemistry, Biocenter, Innsbruck Medical University , Innsbruck , Austria.Mathematical Sciences, Chalmers University of Technology , Gothenburg , Sweden.Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, University of Gothenburg , Gothenburg , Sweden. Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital , Molndal , Sweden.Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, University of Gothenburg , Gothenburg , Sweden. Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital , Molndal , Sweden. Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square , London , UK. UK Dementia Research Institute at UCL , London , UK.Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden. Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital , Gothenburg, Sweden.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31556765

Citation

Yilmaz, Aylin, et al. "Switching From a Regimen Containing Abacavir/lamivudine or Emtricitabine/tenofovir Disoproxil Fumarate to Emtricitabine/tenofovir Alafenamide Fumarate Does Not Affect Central Nervous System HIV-1 Infection." Infectious Diseases (London, England), vol. 51, no. 11-12, 2019, pp. 838-846.
Yilmaz A, Mellgren Å, Fuchs D, et al. Switching from a regimen containing abacavir/lamivudine or emtricitabine/tenofovir disoproxil fumarate to emtricitabine/tenofovir alafenamide fumarate does not affect central nervous system HIV-1 infection. Infect Dis (Lond). 2019;51(11-12):838-846.
Yilmaz, A., Mellgren, Å., Fuchs, D., Nilsson, S., Blennow, K., Zetterberg, H., & Gisslén, M. (2019). Switching from a regimen containing abacavir/lamivudine or emtricitabine/tenofovir disoproxil fumarate to emtricitabine/tenofovir alafenamide fumarate does not affect central nervous system HIV-1 infection. Infectious Diseases (London, England), 51(11-12), pp. 838-846. doi:10.1080/23744235.2019.1670352.
Yilmaz A, et al. Switching From a Regimen Containing Abacavir/lamivudine or Emtricitabine/tenofovir Disoproxil Fumarate to Emtricitabine/tenofovir Alafenamide Fumarate Does Not Affect Central Nervous System HIV-1 Infection. Infect Dis (Lond). 2019;51(11-12):838-846. PubMed PMID: 31556765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Switching from a regimen containing abacavir/lamivudine or emtricitabine/tenofovir disoproxil fumarate to emtricitabine/tenofovir alafenamide fumarate does not affect central nervous system HIV-1 infection. AU - Yilmaz,Aylin, AU - Mellgren,Åsa, AU - Fuchs,Dietmar, AU - Nilsson,Staffan, AU - Blennow,Kaj, AU - Zetterberg,Henrik, AU - Gisslén,Magnus, Y1 - 2019/09/26/ PY - 2019/9/27/pubmed PY - 2019/9/27/medline PY - 2019/9/27/entrez KW - HIV-1 KW - NFL KW - central nervous system KW - cerebrospinal fluid KW - neopterin KW - tenofovir alafenamide fumarate SP - 838 EP - 846 JF - Infectious diseases (London, England) JO - Infect Dis (Lond) VL - 51 IS - 11-12 N2 - Background: Despite suppressive antiretroviral therapy (ART), many HIV-infected individuals have low-level persistent immune activation in the central nervous system (CNS). There have been concerns regarding the CNS efficacy of tenofovir alafenamide fumarate (TAF) because of its low cerebrospinal fluid (CSF) concentrations and because it is a substrate of the active efflux transporter P-glycoprotein. Our aim was to investigate whether switching from emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) or abacavir (ABC)/lamivudine (3TC) to FTC/TAF would lead to changes in residual intrathecal immune activation, viral load, or neurocognitive function. Methods: Twenty HIV-1-infected neuro-asymptomatic adults (11 on ABC/3TC and 9 on FTC/TDF) were included in this prospective study. At baseline, all participants changed their nucleoside analogues to FTC/TAF without any other changes in their ART regimen. We performed lumbar punctures, venipunctures, and neurocognitive testing at baseline and after three and 12 months. Results: During follow-up, there were no significant changes in CSF or plasma HIV RNA, CSF neopterin, CSF β2-microglobulin, IgG index, albumin ratio, CSF NFL, or neurocognitive function in assessed by Cogstate in any of the groups. Conclusion: This small pilot study indicates that switching to FTC/TAF from ABC/3TC or FTC/TDF has neither a positive, nor a negative effect on the HIV infection in the CNS. SN - 2374-4243 UR - https://www.unboundmedicine.com/medline/citation/31556765/Switching_from_a_regimen_containing_abacavir/lamivudine_or_emtricitabine/tenofovir_disoproxil_fumarate_to_emtricitabine/tenofovir_alafenamide_fumarate_does_not_affect_central_nervous_system_HIV-1_infection L2 - http://www.tandfonline.com/doi/abs/10.1080/23744235.2019.1670352 DB - PRIME DP - Unbound Medicine ER -