Abstract
BACKGROUND: Long-term outcome data from real-world studies of the bictegravir emtricitabine tenofovir alafenamide fumarate (B/F/TAF) regimen in the treatment of elderly patients with HIV/AIDS are still limited. This study evaluated the real-world effectiveness and safety of B/F/TAF in elderly HIV-infected individuals in southwest China. METHODS: This was an observational, single-center, retrospective study that enrolled antiretroviral therapy (ART)-naïve (n = 149) and ART-experienced (n = 143) patients with HIV infection between January 2021 and April 2024. The main endpoint was the viral suppression rate of HIV RNA < 50 copies/ml at 48 weeks, and change in CD4 cell count, CD4/CD8 ratio, body weight, blood lipid and safety were secondary endpoints. RESULTS: The proportions of ART-naïve and ART-experienced HIV-infected cases with VL < 50 copies/mL at 48 weeks were 93.1% and 92.9%, respectively. CD4 cell counts and CD4/CD8 ratios increased significantly from baseline at 48 weeks (p < 0.001). In the treatment-naive group, ALT, AST, eGFR, and Glu decreased significantly from baseline at 48 weeks, while body weight, Scr, TC, HDL, and LDL increased significantly. Among patients previously administered ART, eGFR increased significantly from baseline at 48 weeks, while AST, LDL, and Scr decreased significantly; other indicators showed no significant changes from baseline. The incidence rates of adverse events were 11.7% and 4.3% in treatment-naïve and treatment-experienced, respectively. CONCLUSIONS: For elderly HIV/AIDS patients, B/F/TAF is a safe option to achieve and maintain virological suppression and immune recovery. In terms of lipid metabolism, the metabolic effects of BIC/FTC/TAF in the treated patients are not significant, and the effects in untreated patients require longer follow-up.