4.1 Article

Effects of antiretroviral combination therapies F/TAF, E/C/F/TAF and R/F/TAF on insulin resistance in healthy volunteers: the TAF-IR Study

期刊

ANTIVIRAL THERAPY
卷 23, 期 7, 页码 629-632

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INT MEDICAL PRESS LTD
DOI: 10.3851/IMP3271

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  1. Gilead Sciences
  2. German Research Foundation
  3. Technische Universitat Munchen

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Background: Increased insulin resistance (IR), associated with specific antiretroviral drugs or drug classes, is an established risk factor for type 2 diabetes in HIV patients, ultimately increasing morbidity and mortality. To date, data on the risk of IR in tenofovir alafenamide (TAF)-based protocols are unavailable. Methods: This prospective randomized, open-label study evaluated the effects of IR on 30 healthy volunteers receiving fixed-dose combinations (FDCs) of emtricitabine/tenofovir alafenamide (F/TAF), elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) or rilpivirine/emtricitabine/tenofovir alafenamide (R/F/TAF). IR was measured before and after 14-day treatments using the hyperinsulinemic-euglycaemic clamp technique (HEGC). Changes in IR in each group were evaluated using the mean glucose disposal rate, normalized with body weight (M-BW [mg glucose/(minxkg)]). Results: A total of 30 subjects underwent randomization: one subject in the F/TAF arm withdrew consent after randomization and one in the R/F/TAF arm had to be excluded because of technical failure during HEGC, resulting in 28 subjects in the per-protocol population (F/TAF, n=9 subjects; E/C/F/TAF, n=10 subjects; R/F/TAF n=9 subjects). No significant differences were detected on the baseline characteristics. IR did not differ among the groups before treatment. None of the studied anti-retroviral combinations resulted in a significant change in IR after 14 days compared with baseline values, as measured by M-BW, (F/TAF, 11.42 +/- 3.04 mean [+/- SD] versus 11.43 +/- 3.23, P=0.49; E/C/F/TAF, 10.04 +/- 2.49 versus 10.95 +/- 4.26, P=0.30; R/F/TAF, 11.03 +/- 1.96 versus 13.01 +/- 4.11, P=0.13). Conclusions: Short-term treatment for F/TAF, E/C/F/TAF or R/F/TAF did not increase IR in healthy male volunteers.

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