Changes in cardiovascular and metabolic risk scores after switching to DOR/3TC/TDF, DTG/3TC or BIC/FTC/TAF: results from a multicenter Italian cohort

Objective: – To assess changes of cardiovascular risk scores and metabolic scores after switching to DOR/3TC/TDF (DOR group), DTG/3TC (DTG group) or BIC/FTC/TAF (BIC group). Methods: – We analyzed data from 1069 virologically-suppressed people with HIV (PWH), collecting clinical history and laboratory parameters at baseline (date of switch) and 48 weeks of follow-up. In eligible PWH we calculated Body Mass Index (BMI), SCORE-2 for cardiovascular risk assessment and the Metabolic Score for Insulin Resistance (METS-IR) at both timepoints and performed linear mixed model for repeated measures to measure changes in parameters, while using linear regression analyses to search for predictors of change. Results: – After 48 weeks, we observed significant changes in median SCORE-2 in all groups: there were increases of +0.12 in the DTG group (p = 0.021) and +0.30 in the BIC group (<0.001), while we observed a decrease of -0.35 in the DOR group (p < 0.001). In our regression analyses, taking DOR/3TC/TDF was a predictor of reduction of SCORE-2 compared with both DTG (p < 0.001) and BIC (p < 0.001). Regarding BMI, after 48 weeks we observed a median increase of +0.2 in BIC (p < 0.001), no changes in the DTG group and a median decrease of -0.04 in the DOR group (p < 0.001). Regarding METS-IR, after 48 weeks we observed a significant decrease in the DOR group (-0.9, p = 0.024), while there were no significant changes with DTG and an increase of +0.3 with BIC (p = 0.013). Conclusion: – We found that switching to DOR/3TC/TDF was associated with more favorable changes in SCORE-2 and METS-IR compared to DTG/3TC and BIC/FTC/TAF.