Planning HIV therapy to prevent future comorbidities: patient years for tenofovir alafenamide.

摘要: Since the introduction of suppressive antiretroviral therapy (ART), HIV has become a chronic disease, with infected people in high-income countries approaching similar life expectancy to general population. As this population ages, an increasing number are living age-, treatment-, and disease-related comorbidities. Lifestyle factors such as smoking, alcohol abuse, substance misuse have role age-related comorbidity. Some degree immune dysfunction is suggested by presence markers activation/inflammation despite effective suppression replication. Cumulative exposure some drugs contributes HIV-associated comorbidities, risk age. Specifically, tenofovir disoproxil fumarate (TDF), ritonavir-boosted atazanavir, lopinavir associated renal impairment, TDF known cause loss bone mineral density. Tenofovir alafenamide (TAF) was developed improve on safety profile TDF, while maintaining its efficacy. TAF better stability plasma, higher intracellular accumulation diphosphate target cells, which resulted improved antiviral activity at lower doses safety. been studied extensively randomized clinical trials real-world studies. TAF-based regimens recommended over TDF-containing for profile.