Lipids and Body Mass Index in Antiretroviral‐Experienced People With HIV on Doravirine‐Based Treatments: A Comparison Between Dual or Triple Regimen Versus Bictegravir‐Based Triple Regimen

Objective: Toevaluatethelipidpro leandbodymassindex(BMI)inantiretroviral-experiencedpeoplelivingwithHIV(PLWH) starting therapywithtwodoravirine(DOR)-basedregimens(dolutegravir(DTG)/DORorlamivudine(3TC)/tenofovirdisoproxil fumarate (TDF)/DOR). Methods: Data fromtheSurveillanceCohortLong-TermToxicityAntiretrovirals(SCOLTA)prospectivedatabase,includingall experienced PLWHwhostartedtreatmentwithDTG/DORand3TC/TDF/DOR.Toobtainacomparablesample,subjectson emtricitabine (FTC)/tenofoviralafenamide(TAF)/bictegravir(BIC)werematched1:1(bysex,age(±1 year),atleastonebetween dyslipidemia andstatinuse)withthoseon3TC/TDF/DOR. Results: Among 355PLWHonviralsuppression,themedianagewas53years;menrepresented74.9%ofthesample.Atbaseline, 147 peopletreatedwithFTC/TAF/BIChadabetterlipidpro leandlowerCD4cellcountthan147peopletreatedwith3TC/TDF/ DOR; diabeteswaslessfrequentinthelattergroup.After6and12months,theBMIdidnotsigni cantlychangeinanyofthe groups. Totalcholesterol(TC)levelsigni cantlydeclinedinPLWHon3TC/TDF/DORbutnotinFTC/TAF/BICandremained unchanged inDTG/DOR.LDL-Cshowedasimilartrend,withthemostmarkeddeclineinthe3TC/TDF/DORgroupandno diDerence inFTC/TAF/BIC..eTC/HDL-Cratiodeclinedsigni cantlyin3TC/TDF/DORandDTG/DORbutnotinFTC/TAF/ BIC. Overtheentireobservationperiod(median18months,interquartilerange10–30),43(12.1%)PLWHinterruptedthecohort drug, mainlybecauseofadverseevents(n � 15), with12losttofollow-upand12simpli cations. Conclusions: .e regimenswerewelltoleratedintermsoflipidpro leandBMI.Personstreatedwith3TC/TDF/DORtriple regimen showedabetterlipidpro le,asexpected,whereasthoseonDTG/DORdidnotshowanysigni cantchanges.