Lipid and Glucose Profiles in Pregnant Women With HIV on Tenofovir-based Antiretroviral Therapy
Year: 2024
Type: article
Abstract: BACKGROUND: Tenofovir alafenamide (TAF)-based antiretroviral therapy (ART) regimens have been associated with adverse changes in lipid and glucose profiles compared with tenofovir disoproxil fumarate (TDF)-based ART, but data in pregnancy are limited. We evaluated metabolic markers in pregnant women with human immunodeficiency virus (HIV) after starting TAF- versus TDF-based ART. METHODS: We analyzed data within the IMPAACT 2010/VESTED trial, which demonstrated better pregnancy outcomes in pregnant women randomized to initiate TAF/Emtricitabine/Dolutegravir (TAF/FTC + DTG; n = 217) or TDF/FTC + DTG (n = 215). We measured non-fasting plasma concentrations of glucose, total-cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), lipoprotein (a), and triglycerides from samples collected 8 weeks after enrollment. We employed linear regression models to estimate by-arm mean differences. RESULTS: In total, 219 participants enrolled in the DTG arms in Zimbabwe and Uganda: 109 in the TAF/FTC + DTG and 110 in the TDF/FTC + DTG arms. At study entry, mean gestational age was 22.6 weeks, median HIV-1 RNA was 711 copies/mL, and mean age was 25.8 years. By 8 weeks, mean total cholesterol was 12 mg/dL higher in women randomized to TAF/ FTC + DTG versus TDF/FTC + DTG (95% confidence interval [CI]: 3.8, 21.1). Pregnant women in the TAF/FTC + DTG arm had higher mean LDL-C (7.1 mg/dL, 95% CI: .2, 14.0), triglycerides (12.3 mg/dL, 95% CI: 1.8, 22.7), lipoprotein (a) (7.3 mg/dL, 95% CI: 1.1, 13.6), and lower mean HDL-C (2.8 mg/dL, 95% CI: .1, 5.6) compared to the TDF/FTC + DTG arm. CONCLUSIONS: Pregnant women randomized to start TAF/FTC + DTG had higher lipids than those randomized to TDF/FTC + DTG within 8 weeks of ART initiation. However, lipid levels were within normal reference ranges.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciae441
Authors: Ahizechukwu C Eke, Sean S Brummel, Muktar H Aliyu, Lynda Stranix-Chibanda, George U Eleje, Ifeanyichukwu U Ezebialu, Violet Korutaro, Deo Wabwire, Allen Matubu, Tapiwa Mbengeranwa, Nahida Chakhtoura, Lameck Chinula, Katie McCarthy, Kevin Knowles, Chelsea Krotje, Macrae F Linton, Kelly E Dooley, Paul E Sax, Todd Brown, Shahin Lockman, IMPAACT 2010/VESTED Study Team, Sharon Nachman, James McIntyre, David P Harrington, Catherine Hill, Steven Joffe, Alwyn Mwinga, Andrew J Nunn, Haroon Saloojee, Merlin L Robb, Jonathan Kimmelman, Graeme A Meintjes, Barbara E Murray, Stuart Campbell Ray, Haroon Saloojee, Anastasios A Tsiatis, Paul A Volberding, David Glidden, Valeria Cavalcanti Rolla, Nahida Chakhtoura, Renee Browning, Jeanna Piper, Karin Klingman, Debika Bhattacharya, Patrick Jean-Philippe, Lynne Mofenson, Sean Brummel, Lauren Ziemba, Mauricio Pinilla, Chelsea Morroni, Benjamin Johnston, Chelsea Krotje, Scott McCallister, Jean van Wyk, Mark Mirochnick, Brookie Best, Kevin Robertson, Cheryl Blanchette, Nagawa Jaliaah, Andee Fox, Frances Whalen, Kevin Knowles, William Murtaugh, Mauricio Pinilla, Yao Cheng, Emmanuel Patras
Institutions: Johns Hopkins University, Johns Hopkins Medicine, Vanderbilt University, Vanderbilt University Medical Center, University of Zimbabwe, Nnamdi Azikiwe University, Nnamdi Azikiwe University Teaching Hospital, Chukwuemeka Odumegwu Ojukwu University, Baylor College of Medicine Children’s Foundation, MUJHU Research Collaboration, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, University of North Carolina at Chapel Hill, Family Health International 360, Frontier Science & Technology Research Foundation, Inc., Brigham and Women's Hospital, Harvard University, Botswana Harvard AIDS Institute Partnership
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: Amgen, Sanofi, Gilead Sciences, Patient-Centered Outcomes Research Institute, Regeneron Pharmaceuticals, International Maternal Pediatric Adolescent AIDS Clinical Trials Network, National Institutes of Health, EMD Serono, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1220961632, G1288914450, G1781567339, G1857750563, G1942626157, G2383610615, G3045663399, G3220087362, G3262353703, G32641939, G3342746445, G3665517470, G4362108469, Integrated proteomic and metabolomic biomarker profiling for understanding metabolic syndrome in pregnant women living with HIV on Tenofovir Disoproxil Fumarate/Lamivudine/Dolutegravir (TLD), G4557618845, G4853082081, G4927240118, G5517827652, G5602729146, G6488665543, G6585143688, G7502524018, G765734810, G803170016, G8500352392, G8922259349, G9000030691, Tennessee Center for AIDS Research (TN-CFAR), G9000153711, G9000283430, G9000294451, G9000313355, SDMC - IMPAACT Leadership Group, University of North Carolina Global HIV Prevention and Treatment Clinical Trials Unit
OpenAlex ID: W4402134901