Tenofovir-Containing Antiretroviral Therapy and Clinical Outcomes of SARS-CoV-2 Infection in People Living with HIV

Author:

Rombini María F.1,Cecchini Diego12ORCID,Diana Menendez Sofía1,Calanni Liliana3ORCID,Cuini Rosana4,Obieta Elena5,Greco María M.6,Morales Fabricio7ORCID,Morganti Laura2,Migazzi Claudia8,El Kozah Yasmin15,Parenti Pablo9,Cassetti Isabel1,

Affiliation:

1. Helios Salud, Buenos Aires 1141, Argentina

2. Hospital Cosme Argerich, Buenos Aires 1155, Argentina

3. CEIN Unidad Infectológica Neuquén, Neuquén 8300, Argentina

4. Hospital Teodoro Álvarez, Buenos Aires 1406, Argentina

5. Hospital Municipal Ciudad de Boulogne, Boulogne 1609, Argentina

6. Hospital Español de La Plata, La Plata 1902, Argentina

7. IPTEI, Buenos Aires 1415, Argentina

8. Hospital Presidente Perón de Avellaneda, Avellaneda 1872, Argentina

9. CAICI, Rosario 2000, Argentina

Abstract

Tenofovir has been hypothesized to be effective against COVID-19 and is available as two prodrugs, tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), both part of antiretroviral therapy (ART) regimens. People living with human immunodeficiency virus (PLWH) might be at higher risk for COVID-19 progression; however, information about the impact of tenofovir on COVID-19 clinical outcomes remains controversial. The COVIDARE is a prospective observational multicentric study in Argentina. PLWH with COVID-19 were enrolled from September 2020 to mid-June 2022. Patients were stratified according to baseline ART into those with tenofovir (TDF or TAF) and those without. Univariate and multivariate analyses were performed to evaluate the impact of tenofovir vs. non-tenofovir-containing regimens on major clinical outcomes. Of the 1155 subjects evaluated, 927 (80%) received tenofovir-based ART (79% TDF, 21% TAF) whilst the remaining population was under non-tenofovir regimens. The non-tenofovir group had older age and a higher prevalence of heart and kidney disease. Regarding the prevalence of symptomatic COVID-19, tomographic findings, hospitalization, and mortality, no differences were observed. The oxygen therapy requirement was higher in the non-tenofovir group. In the multivariate analyses, a first model with adjustment for viral load, CD4 T-cell count, and overall comorbidities showed that oxygen requirement was associated with non-tenofovir ART. In a second model with adjustment by chronic kidney disease, tenofovir exposure was not statistically significant.

Publisher

MDPI AG

Subject

Virology,Infectious Diseases

Reference38 articles.

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