Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain.
Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain.
J Antimicrob Chemother. 2022 Jul 28;77(8):2265-2273. doi: 10.1093/jac/dkac177.
Reports on the impact of some antiretrovirals against SARS-CoV-2 infection and disease severity are conflicting.
We evaluated the effect of tenofovir as either tenofovir alafenamide/emtricitabine (TAF/FTC) or tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) against SARS-CoV-2 infection and associated clinical outcomes among people living with HIV (PLWH).
We conducted a propensity score-matched analysis in the prospective PISCIS cohort of PLWH (n = 14 978) in Catalonia, Spain. We used adjusted Cox regression models to assess the association between tenofovir and SARS-CoV-2 outcomes.
After propensity score-matching, SARS-CoV-2 diagnosis rates were similar in TAF/FTC versus ABC/3TC recipients (11.6% versus 12.5%, P = 0.256); lower among TDF/FTC versus ABC/3TC recipients (9.6% versus 12.8%, P = 0.021); and lower among TDF/FTC versus TAF/FTC recipients (9.6% versus 12.1%, P = 0.012). In well-adjusted logistic regression models, TAF/FTC was no longer associated with reduced SARS-CoV-2 diagnosis [adjusted odds ratio (aOR) 0.90; 95% confidence interval (CI), 0.78-1.04] or hospitalization (aOR 0.93; 95% CI, 0.60-1.43). When compared with ABC/3TC, TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.79; 95% CI, 0.60-1.04) or hospitalization (aOR 0.51; 95% CI, 0.15-1.70). TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.79; 95% CI, 0.60-1.04) or associated hospitalization (aOR 0.33; 95% CI, 0.10-1.07) compared with TAF/FTC.
TAF/FTC or TDF/FTC were not associated with reduced SARS-CoV-2 diagnosis rates or associated hospitalizations among PLWH. TDF/FTC users had baseline characteristics intrinsically associated with more benign SARS-CoV-2 infection outcomes. Tenofovir exposure should not modify any preventive or therapeutic SARS-CoV-2 infection management.
关于某些抗逆转录病毒药物对 SARS-CoV-2 感染和疾病严重程度的影响的报告相互矛盾。
我们评估了替诺福韦作为替诺福韦艾拉酚胺/恩曲他滨（TAF/FTC）或替诺福韦富马酸二异丙酯/恩曲他滨（TDF/FTC）在感染 HIV 的人群（PLWH）中对 SARS-CoV-2 感染和相关临床结局的影响。
我们在西班牙加泰罗尼亚的前瞻性 PISCIS 队列中对 PLWH（n = 14978）进行了倾向评分匹配分析。我们使用调整后的 Cox 回归模型评估了替诺福韦与 SARS-CoV-2 结局之间的关联。
在倾向评分匹配后，TAF/FTC 组与 ABC/3TC 组的 SARS-CoV-2 诊断率相似（11.6%比 12.5%，P = 0.256）；TDF/FTC 组低于 ABC/3TC 组（9.6%比 12.8%，P = 0.021）；TDF/FTC 组也低于 TAF/FTC 组（9.6%比 12.1%，P = 0.012）。在经过充分调整的逻辑回归模型中，TAF/FTC 与 SARS-CoV-2 诊断减少无关[调整后的优势比（aOR）0.90；95%置信区间（CI），0.78-1.04]或住院治疗（aOR 0.93；95%CI，0.60-1.43）。与 ABC/3TC 相比，TDF/FTC 与 SARS-CoV-2 诊断减少无关（aOR 0.79；95%CI，0.60-1.04）或住院治疗（aOR 0.51；95%CI，0.15-1.70）。与 TAF/FTC 相比，TDF/FTC 与 SARS-CoV-2 诊断减少无关（aOR 0.79；95%CI，0.60-1.04）或相关住院治疗（aOR 0.33；95%CI，0.10-1.07）。
TAF/FTC 或 TDF/FTC 与 PLWH 中 SARS-CoV-2 诊断率降低或相关住院治疗无关。TDF/FTC 使用者具有与 SARS-CoV-2 感染结局更良性相关的基线特征。替诺福韦暴露不应改变任何预防或治疗 SARS-CoV-2 感染的管理。
