Equivalent Decline in Inflammation Markers with Tenofovir Disoproxil Fumarate vs. Tenofovir Alafenamide

Background: Initiation of antiretroviral therapy (ART) and subsequent virologic suppression reduces immune activation and systemic inflammation. Methods: We examined longitudinal changes in biomarkers of monocyte activation (sCD14, sCD163), and systemic (IL-6, hsCRP, sTNFR-I and D-dimer) and vascular (Lp-PLA(2)) inflammation in a subgroup (N = 100 per arm) of participants enrolled in a randomized, placebo-controlled trial comparing elvitegravir/cobicistat/ emtricitabine/tenofovir alafenamide (E/C/F/TAF; TAF) to E/C/F/tenofovir disoproxil fumarate (E/C/F/TDF; TDF) in treatment-naive adults. Results: For 194 participants (TAF, 98; TDF, 96), baseline levels of biomarkers did not differ by treatment arm; there were no differences in biomarker values between groups at weeks 12, 24, or 48 (p > 0.05), except IL-6 at week 12 (p = 0.012). Among all participants (combining groups), there were statistically significant declines from baseline observed for D-dimer, sCD163, and sTNFR-1 by week 12 and IL-6 by week 24. The proportion of participants with Lp-LA(2) levels b 200 ng per mL (p = 0.250) or hsCRP levels <3000 mg per L (p = 0.586) was unchanged through week 48. Conclusions: We observed equivalent declines in biomarkers of monocyte activation and systemic inflammation in treatment-naive adults treated with TAF or TDF for 48 weeks, suggesting that TAF and TDF have equivalent impact on immune activation and inflammation. (C) 2016 The Authors. Published by Elsevier B.V.