Evidence map›Paper›PMID 29682298›Full record

ArticleJournal of virus eradication2018

Tenofovir alafenamide versus tenofovir disoproxil fumarate: is there a true difference in efficacy and safety?

Andrew Hill, Sophie L Hughes, Dzintars Gotham, Anton L Pozniak

2 registry-linked trialsOpen access · greenAbstract readEditorial
PubMed Full text at PMC
In one paragraph

Article in Journal of virus eradication, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 72 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03646370 completednot on this map

Assessing Virologic Success and Metabolic Changes in Patients Switching From a TDF to TAF Containing Antiretroviral Therapy Regimen

TypeobservationalSponsorThomas Jefferson UniversityRan2018 to 2019Enrolled110ConditionsHIV-1-infection, Metabolic Syndrome, Cardiovascular Diseases, Weight GainArmsTenofovir Alafenamide
NCT04665375 phase4terminatednot on this mapstarted 2021, after this paper: background citation

Can the Weight Gain Associated With Use of Integrase Strand Inhibitors be Halted or Reversed With a Switch to Doravirine/Lamivudine/Tenofovir DF in Patients Living With HIV? (DeLiTE)

TypeinterventionalSponsorUniversity Health Network, TorontoRan2021 to 2024Enrolled4ConditionsHiv, Weight GainArmsDOR/3TC/TDF
3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 7 syntheses or guidelines pooled it, 96 citations in OpenAlex.

  1. Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV - CDC Recommendations, United States, 2025.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2025
    Guideline
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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Andrew HillDepartment of Pharmacology and Therapeutics, University of Liverpool, UK.
Sophie L HughesFaculty of Medicine, Imperial College London, UK.
Dzintars GothamFaculty of Medicine, Imperial College London, UK.
Anton L PozniakChelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Imperial College London · GBChelsea and Westminster Hospital NHS Foundation Trust · GBUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigher plasma tenofovir concentrations are associated with higher risks of renal and bone adverse events. The pharmacokinetic boosters ritonavir (RTV) and cobicistat (COBI) significantly increase plasma area under the curve (AUC) concentrations of tenofovir disoproxil fumarate (TDF), by 25-37%. When combined with RTV or COBI, the dose of tenofovir alafenamide (TAF) is lowered from 25 mg to 10 mg daily, but the TDF dose is maintained at 300 mg daily.

objectiveTo assess the differences in safety and efficacy between tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) in regimens with and without the pharmacokinetic boosters RTV and COBI.

methodsA PubMed/Embase search inclusive of dates up to 17 July 2017 identified 11 randomised head-to-head trials (8111 patients) of TDF versus TAF. The Mantel-Haenszel method was used to calculate pooled risk differences and 95% confidence intervals using random-effects models. A pre-defined sub-group analysis compared TAF with TDF, either when boosted with RTV or COBI, or when unboosted.

resultsNine clinical trials compared TAF and TDF for treatment of HIV-1 and two were for hepatitis B treatment. The eleven clinical trials documented 4574 patients with boosting RTV or COBI in both arms, covering 7198 patient-years of follow-up. Some 3537 patients received unboosted regimens, totalling 3595 patient-years of follow-up. Boosted TDF-treated patients showed borderline lower HIV RNA suppression <50 copies/mL (

conclusionsTDF boosted with RTV or COBI was associated with higher risks of bone and renal adverse events, and lower HIV RNA suppression rates, compared with TAF. By contrast, when ritonavir and cobicistat were not used, there were no efficacy differences between TAF and TDF, and marginal differences in safety. The health economic value of TAF versus low-cost generic TDF may be limited when these drugs are used without cobicistat or ritonavir.

Indexed as

antiretroviral therapy; bone density; cobicistat; HIV; kidney; ritonavir; tenofovir

Identifiers

PMID29682298
PMCPMC5892670
OpenAlexW2960874370

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.