{
  "abstract": "Background In people living with HIV (PLWH), the choice of antiretroviral regimen should take into account not only the maintenance of antiviral efficacy, but also long-term metabolic impact. Although highly effective, integrase strand transfer inhibitor (INSTI)-based regimens have been associated with weight gain and metabolic alterations. Regimens based on doravirine (DOR), a newer-generation non-nucleoside reverse transcriptase inhibitor (NNRTI), have shown a favorable lipid profile in clinical trials, but comparative real-world data after switching to DOR/3TC/TDF versus BIC/FTC/TAF remain limited. The aim of this study was to assess changes in lipid profile at 48 and 96 weeks.Methods This is a retrospective single-center observational study including treatment-experienced PWH virologically suppressed (HIV-RNA <50 copies/mL), switching either to BIC/FTC/TAF (BIC) or DOR/3TC/TD (DOR) between 2019 and 2025, and followed up to week 48 (48W) and for a smaller proportion to week 96 (96W). We assessed change in lipid profile and blood glucose over time. We also evaluated probability of experiencing virological failure (VF, i.e. two consecutive HIV-RNA ≥ 50 copies/mL or a single HIV-RNA ≥1000 copies/mL), the rate of treatment discontinuation (TD) and change in both CD4 cell count and CD4/CD8 over time. A repeated-measures mixed model was used to evaluate the dynamic of parameters over time. Time to VF and TD were assessed by survival analysis.Results We enrolled a total of 519 PLWH, of whom 429 switched to BIC and 90 to DOR. Baseline characteristics including lipid parameters were similar between groups, but participants in BIC were younger (p=0.005) with higher zenith HIV-RNA (p=0.048) and higher CD4 cell counts (p=0.002) ( table 1). At 48W, a significant decrease in both total cholesterol and LDL was observed (-7.9 and -6.0, respectively, both p<0.001), with no significant differences between regimens (p=0.764 and 0.364, respectively). At 96W, the reduction in LDL cholesterol persisted (-5, p=0.003), while no significant changes were observed in the other metabolic parameters. At both 48W and 96W, triglycerides and blood glucose showed no variation in either group. Regarding immunological profile, CD4 cell count significantly increased at 48W (+39, p=0.020), with a greater rise in the DOR group than in the BIC group (p<0.001); overall no significant variations was observed at 96W, however a greater gain was found in the DOR group (p<0.001). The probability of virological failure was similar between the groups (6.1% vs 4.4%, p=0.881), while TD was more frequent with DOR (13.1% vs 18.9%, p=0.044).Conclusions Both BIC/FTC/TAF and DOR/3TC/TDF were effective switch options in virologically suppressed PLWH, ensuring durable virological control and favorable lipid effect up to 96W. These findings support their use in clinical practice, particularly when metabolic profile is a relevant consideration.Abstract P156 Table 1Characteristics of the study participants",
  "authors": [
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "S Colaiuda"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "C De Vivo"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "G Lenzi"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "G Cucinotta"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "F La Fata"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "L Spina"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "A Carbone"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy",
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"
      ],
      "name": "P F Salvo"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy"
      ],
      "name": "F Lombardi"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy",
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"
      ],
      "name": "G Baldin"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy",
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"
      ],
      "name": "C Torti"
    },
    {
      "affiliations": [
        "Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy",
        "Dipartimento di Scienze Mediche e Chirurgiche, UOC Malattie Infettive, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"
      ],
      "name": "S Di Giambenedetto"
    }
  ],
  "title": "P156 Metabolic impact and cardiovascular risk after switching to BIC/FTC/TAF vs DOR/3TC/TDF in a real-world cohort of virologically suppressed PLWH",
  "uid": "55b703a1-a813-5d2e-9cfe-fa9b63a57287"
}