inPractice® - Modifying NRTIs in Virologically Suppressed Patients

Limb fat mass increased significantly from baseline in patients switching from stavudine- or zidovudine-based regimens with clinical evidence of lipoatrophy at baseline^{[Moyle 2006; Fisher 2009; Tebas 2009]}
Several studies have demonstrated improvements in lipids when switching from abacavir/lamivudine to emtricitabine/tenofovir DF in combination with either efavirenz^{[Moyle 2015]} or lopinavir/ritonavir^{[Behrens 2012]} or different boosted PIs^{[Campo 2013]}
In Study 109, switching from tenofovir DF–containing ART regimen to cobicistat/elvitegravir/emtricitabine/tenofovir alafenamide was associated with significantly higher rate of maintained virologic suppression and significant improvements in bone health and proximal tubular function endpoints at Week 48 vs continuing tenofovir DF–containing ART^{[Mills 2016]}