Maria Aurora Carleo, Paolo Bonfanti, Antonio Di Biagio, Sergio Ferrara, Giovanni Cenderello, Katia Falasca, Olivia Bargiacchi, Salvatore Martini, Eleonora Sarchi, Stefano Rusconi, Leonardo Calza, Laura Valsecchi, Lucia Taramasso, Andrea Parisini, Antonio Cascio, Paolo Maggi, Giovanni Francesco Pellicanò, Giordano Madeddu, Benedetto Maurizio Celesia, Francesca Vichi, Rita Bellagamba, Barbara Menzaghi, Giancarlo Orofino, Addolorata Masiello, Chiara Molteni, Nicola Squillace, Giuseppe Vittorio De Socio, Canio Vito Martinelli, Elena Delfina Ricci
Journal: Viruses 2023;15(7):1612
PMID: 37515298
Doravirine (DOR) is a newly approved non-nucleoside reverse transcriptase inhibitor (NNRTI). We aimed to investigate, in a real-life setting, how switching to a DOR-based regimen rather than a rilpivirine (RPV)-based regimen impacted metabolic and hepatic safety. The analysis included 551 antiretroviral treatment (ART)-experienced people living with HIV (PLWH), starting RPV-based or DOR-based regimens with viral load < 200 copies/mL, baseline (T0), and at least one control visit (6-month visit, T1). We enrolled 295 PLWH in the RPV and 256 in the DOR cohort. At T1, total cholesterol (TC), low-density lipoprotein-C (LDL-C), and triglycerides significantly decreased in both DOR and RPV cohorts, while high-density lipoprotein-C (HDL-C) only decreased in RPV-treated people. Consistently, the TC/HDL-C ratio declined more markedly in the DOR (-0.36, < 0.0001) than in the RPV cohort (-0.08, = 0.25) (comparison = 0.39). Similar trends were observed when excluding the PLWH on lipid-lowering treatment from the analysis. People with normal alanine aminotransferase (ALT) levels showed a slight ALT increase in both cohorts, and those with baseline ALT > 40 IU/L experienced a significant decline (-14 IU/L, = 0.008) only in the DOR cohort. Lipid profile improved in both cohorts, and there was a significant reduction in ALT in PLWH with higher-than-normal baseline levels on DOR-based ART.
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