Changes in blood lipid levels and influencing factors among treatment-naive adult male HIV/AIDS patients following BIC/FTC/TAF vs.3TC+EFV+TDFOACSTPCDMEDLINE

Background:Antiretroviral therapy(ART)was often associated with dyslipidemia among human immunodeficiency virus(HIV)/acquired immunodeficiency syndrome(AIDS)patients.This study aimed to assess treatment-naïve adult male patients with HIV/AIDS who initiated ART with either co-formulated bictegravir,emtricitabine,and tenofovir alafenamide(BIC/FTC/TAF)or lamivu-dine,efavirenz,and tenofovir disoproxil fumarate(3TC+EFV+TDF),monitoring at weeks 4,12,24,and 48. Methods:A case-control retrospective study was conducted.The newly diagnosed HIV-infected individuals attending the sexual transmission disease(STD)/AIDS clinic of Beijing Youan Hospital,Capital Medical University,from January to December 2021.The patients were divided into BIC/FTC/TAF group or 3TC+EFV+TDF group.High-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG),and total cholesterol(TC)at different time points over 48 weeks between two groups were compared.A multivariate Cox regression model was used to identify relevant influencing factors for the population at high risk of increased LDL-C. Results:A total of 870 participants,with 510 in BIC/FTC/TAF group and 360 in 3TC+EFV+TDF group.There were no statis-tically significant differences in median age,baseline CD4/CD8 ratio,median body mass index(BMI)between the two groups.In both two groups,levels of TG,TC,and LDL-C were higher at 4 weeks,12 weeks,and 24 weeks of treatment(all P＜0.05),and there were no statistically significant differences at 48 weeks compared to those at baseline(all P＞0.05).In addition,the differences in average changes of the level of TG,TC,HDL-C,and LDL-C from weeks 4,12,24,and 48 to baseline between two groups were not statistically significant(all P＞0.05).Multivariate Cox proportional risk model analysis showed that initiating ART with HIV RNA ≥105 copies/mL(compared with＜105 copies/mL)was associated with an increased risk of elevated LDL-C(hazard ratio=1.26,95％confidence interval:1.07-1.48,P=0.005). Conclusions:Transient elevations in blood lipid levels(TC,TG,HDL-C,and LDL-C)were observed in treatment-naïve adult male HIV/AIDS patients with BIC/FTC/TAF at 4 weeks,12 weeks,and 24 weeks of treatment.However,these levels did not differ sig-nificantly from baseline after 48 weeks of treatment,regardless of whether patients were in the BIC/FTC/TAF or 3TC+EFV+TDF group.