在欧洲感染艾滋病毒的儿童和年轻人中，与基于富马酸替诺福韦二吡呋酯和阿巴卡韦的疗法相比，基于富马酸丙酚替诺福韦的疗法导致的体重增加情况。

OBJECTIVE

To compare BMI-for-age z-score (zBMI) changes in treatment-experienced children and young people living with HIV aged 6 to <25 years on tenofovir alafenamide fumarate (TAF) to those on tenofovir disoproxil fumarate (TDF) and abacavir (ABC).

METHODS

Cohort study of children and young people living with HIV from 12 European countries were grouped by drug exposure: 1 - on TAF with prior TDF use; 2 - on TAF no prior TDF; 3 - on TDF; and 4 - on ABC. Outcomes, adjusted for characteristics at drug start, were (i) incidence of overweight or obesity by 96 weeks, (ii) zBMI change 48 weeks before/after drug start, (iii) association between TAF/TDF/ABC and anchor drug on zBMI change and (iv) factors associated with zBMI change on TAF over 96 weeks.

RESULTS

Overall, 162, 189, 270 and 144 were in groups 1, 2, 3 and 4, respectively. Median ages at drug start were 16, 13, 14 and 12 years. Obesity incidence by 96 weeks was 16%, 13%, 6% and 12% and higher on TAF than TDF (p = 0.018) but comparable to ABC (p = 0.568). Similar trends were seen for overweight/obesity, although differences were not significant. Over 48 weeks, zBMI increased at a higher rate on TAF than TDF (p = 0.001) but similar to ABC (p = 0.652). zBMI change was higher after than before drug start in group 1 (p = 0.059) but similar in other groups. Over 96 weeks zBMI change on TAF/TDF/ABC combined with dolutegravir vs. other anchor drugs was not statistically different (p = 0.196). zBMI change on TAF varied by age (p = 0.001), prior TDF (p = 0.019), viral load (p = 0.042) and zBMI (p = 0.004) at TAF start.

CONCLUSION

zBMI increased on TAF, faster than TDF, but similar to ABC. Weight gain on TAF was associated with multiple factors including prior TDF use.

目的

比较接受过治疗的6至未满25岁感染艾滋病毒的儿童和青少年中，使用富马酸替诺福韦艾拉酚胺（TAF）与使用富马酸替诺福韦二吡呋酯（TDF）及阿巴卡韦（ABC）的人群中年龄别体重指数z评分（zBMI）的变化情况。

方法

对来自12个欧洲国家的感染艾滋病毒的儿童和青少年进行队列研究，根据药物暴露情况分组：1组 - 曾使用TDF后改用TAF；2组 - 未使用过TDF直接使用TAF；3组 - 使用TDF；4组 - 使用ABC。在对用药起始时的特征进行校正后，观察的结果包括：（i）96周时超重或肥胖的发生率；（ii）用药起始前/后48周的zBMI变化；（iii）TAF/TDF/ABC与对照药物对zBMI变化的关联；（iv）96周内TAF治疗期间与zBMI变化相关的因素。

结果

总体而言，1组、2组、3组和4组分别有162人、189人、270人和144人。用药起始时的中位年龄分别为16岁、13岁、14岁和12岁。96周时肥胖发生率分别为16%、13%、6%和12%，TAF组高于TDF组（p = 0.018），但与ABC组相当（p = 0.568）。超重/肥胖情况也呈现类似趋势，尽管差异不显著。在48周内，TAF组zBMI的上升速度高于TDF组（p = 0.001），但与ABC组相似（p = 0.652）。1组用药起始后zBMI变化高于用药起始前（p = 0.059），其他组则相似。在96周内，TAF/TDF/ABC联合多替拉韦与其他对照药物相比，zBMI变化无统计学差异（p = 0.196）。TAF治疗期间zBMI的变化因年龄（p = 0.001）、既往TDF使用情况（p = 0.019）、病毒载量（p = 0.042）以及TAF起始时的zBMI（p = 0.004）而有所不同。