การศึกษาประสิทธิภาพและผลข้างเคียงของการใช้ยา Tenofovir alafenamide  แทน Tenofovir disoproxil fumarate ในการรักษาผู้ติดเชื้อเอชไอวี โรงพยาบาลลานสกา

Kiattiya Waiyakarn; Kittipong Boonlong

Authors

Kiattiya Waiyakram Lansaka Hospital
Kittipong Boonlong Faculty of Engineering,Burapha University

Keywords:

HIV Infection, Renal Function, Lipid Profile

Abstract

This retrospective cohort study aimed to compare changes in renal function, serum lipid levels, immune status, and body weight among people living with HIV after switching antiretroviral therapy from Tenofovir disoproxil fumarate (TDF) to Tenofovir alafenamide (TAF). The study sample consisted of medical records and laboratory results from 71 HIV-infected patients receiving care at Lansaka Hospital, Nakhon Si Thammarat Province, Thailand, who had been switched to TAF for at least six months between May 2024 and October 2025. The research instrument was a data collection form developed by the researchers, comprising general patient information, clinical data, and laboratory test results, which underwent content validity assessment by three experts. Data were analyzed using paired t-tests and reported as means, standard deviations, with statistical significance set at p-value < .05. The study findings revealed the following:

1. Efficacy in suppressing HIV viral load did not differ between TDF and TAF formulations. Ninety-seven-point two percent (97.20 %) of patients-maintained HIV viral load levels below 50 copies/mL after medication switching, with only 2 patients showing viral loads of 50 and 58 copies/mL, respectively. CD4 count showed a slight but statistically significant decrease (p-value = .008), whereas CD4 percentage showed no significant difference (p-value = .087).

2. After switching to TAF, renal function improved significantly. Estimated glomerular filtration rate (eGFR) increased from M = 37, SD = 12.11 to M = 77.27, SD = 13.96 mL/min/1.73 m² (p-value < .001), and serum creatinine decreased from M = 1.13, SD = 0.22 to M = 1.04, SD = 0.23 mg/dL (p-value < .001). Total cholesterol, HDL, and LDL levels increased significantly (p-value < .001), while triglyceride levels showed no significant change (p = 0.117). Body weight increased significantly overall (p-value = .005), with this increase observed in female patients (p-value = .002) but not in male patients.

Switching antiretroviral therapy from TDF to TAF was associated with improved renal function; however, it may increase serum lipid levels and body weight in some patients. Continuous monitoring of laboratory values and ongoing assessment of metabolic risk factors are recommended.

In addition, This research can serve as a guideline for selecting appropriate antiretroviral formulations to enhance efficacy and safety in HIV care management, as well as inform the development of antiretroviral therapy policies within Thailand's public health system.

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