Switching to a Bictegravir Single Tablet Regimen in Elderly People Living with HIV-1: Data Analysis from the BICTEL Cohort

Abstract

Bictegravir/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF) is a recommended once-daily single tablet regimen for the treatment of people living with HIV-1 (PLWH). We aimed to assess efficacy, safety and tolerability of BIC/FTC/TAF among PLWH, with a specific focus on people older than 55 years. Thus, we recruited an observational retrospective real-life cohort including all PLWH who underwent a therapeutic switch to BIC/FTC/TAF, independently from the provenience treatment regimen. After 48 weeks of follow-up, 147 PLWH were included and 93 were older than 55 years. PLWH with HIV-RNA < 37 copies/mL increased from 140 to 146 (<i>p</i> < 0.033). Among the overall population, we observed an increase in CD4⁺ T cells count by 30.1% (<i>p</i>-value < 0.001), in CD8⁺ T cells count by 7.1% (<i>p</i>-value = 0.004) and in CD4⁺/CD8⁺ ratio by 21.5% (<i>p</i>-value < 0.001). Lipidic profile was characterized by decreasing total cholesterol/HDL ratio by 8% (<i>p</i>-value < 0.001) and LDL by 6.8% (<i>p</i>-value = 0.007). Total body weight increased by 1.8% (<i>p</i>-value = 0.014) and BMI by 4.2% (<i>p</i>-value < 0.001), even remaining within the healthy range. Hepatic and renal profile were not altered by the switch, nor were adverse events and/or discontinuations events detected. In conclusion, BIC/FTC/TAF is effective, safe and well tolerated in real life and among PLWH older than 55.