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Switching Back to Older Tenofovir Improves Lipid Levels

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Jim Allen:
To be honest, there a few things not directly related to this study that make me uncomfortable about posting this one.

Anyhow, this study looked at 385 people, after switching from TDF to TAF mean total cholesterol (TC) increased mainly due to an increase in LDL-cholesterol, triglycerides also increased and switching back resulted in a drop in cholesterol & triglycerides   

Switching Back to Older Tenofovir Improves Lipid Levels
https://www.poz.com/article/switching-back-older-tenofovir-improves-lipid-levels

In short:


--- Quote ---People who experienced greater increases in total cholesterol after switching from TDF to TAF also showed more pronounced decreases after going back to TDF, the study authors noted.

"The results demonstrate a reversible effect on lipids of switching from TDF to TAF and back," they wrote.

Although this analysis did not focus on whether kidney function and bone markers also revert to their original levels after switching from TDF to TAF and back again, the findings suggest that returning to TDF may be a feasible strategy for those concerned about elevated lipids while taking TAF.
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daveR:
Can't win for loosing. What you are supposed to gain in one hand you give back with the other. I think I will just stick to good old TDF, a lot of people take it and are still alive to talk about it. Which is the main thing.

Dave

harleymc:
The TDF / TAF choice is really about finding what works best in terms of any potential side effects depending on the individual.

Some of the earlier medications circa about 2000 - 2002 had my cholesterol and triglycerides off the scale.  I was anticipating that when I shifted from TDF to TAF I might get a similar problem, but for me both forms of Tenofovir have been great.

It can be a juggling act especially for folks who are taking medications for other conditions/ co-morbidities.

Delby:
This is interesting. I'm currently on Complera but am going to be switching to Odefsey in a couple of weeks. It's been sanctioned by my Dr in the UK as they are concerned about my bone density due to repeated courses of high dose steriods in order to treat my IBD.

I am now concerned that it may lead to an increase in cholesterol and triglycerides. I'll bring it up with the Dr, but hoping this won't be the case.

Jim Allen:
Posting in this thread as it's related.

POZ.com write-up in full: https://www.poz.com/article/newer-formulation-tenofovir-linked-elevated-blood-lipids

In Short:

--- Quote ---Newer Formulation of Tenofovir Linked to Elevated Blood Lipids
Switching from TDF to TAF was associated with a less favorable blood fat profile.

All participants switched from an antiretroviral regimen containing TDF to one containing TAF. After the switch, 19% of those on TAF were taking a protease inhibitor as an anchor drug, and 61% were on a boosting agent as well.

At baseline, 29% of people who switched had an atherosclerotic cardiovascular disease (ASCVD) risk score indicative of a substantial risk for cardiovascular disease. The ASCVD score has been found to undercount the number of people with HIV who have arterial plaques.

Once people switched, total cholesterol rose by 10 milligrams per deciliter (from 174 to 184), low-density lipoprotein (LDL, or “bad cholesterol”) rose by 7 mg/dL (from 97 to 104) and triglycerides rose by 12 mg/dL (from 127 to 139). High-density lipoprotein (HDL, or “good cholesterol”) also rose, but only slightly, from a median of 45 to 46 mg/dL. When the researchers looked only at the people who switched to TAF without changing their anchor drug, the results were roughly the same, and all the changes were statistically significant. 
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