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Risks of hypertension with first-line dolutegravir (DTG) and tenofovir alafenamide (TAF) in the NAMSAL and ADVANCE trials
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Risks of hypertension with first-line dolutegravir (DTG) and tenofovir alafenamide (TAF) in the NAMSAL and ADVANCE trials

Francois Venter, Simiso Sokhela, Bronwyn Bosch, Godspower Akpomiemie, Manya Mirchandani, Kaitlyn Mccann, Mireille Mpoudi-Etame, Aydee-Tamara Tovar Sanchez, Marwân-Al-Qays Bousmah, Alexandra Calmy, …
12th IAS Conference on HIV Science (Brisbane, South Africa, 23/07/2023–26/07/2023)

Résumé

BACKGROUND: Hypertension is a leading cause of death in sub-Saharan Africa, with a high background prevalence in the general population. First-line use of TAF and DTG lead to higher risks of clinical obesity than tenofovir disoproxil fumarate (TDF) or efavirenz (EFV). Clinical obesity increases the risks of hypertension and other non-communicable diseases (NCDs).METHODS: In the NAMSAL trial, 613 PLWH in Cameroon were randomised to TDF/3TC/DTG or TDF/3TC/EFV (EFV low-dose). In the ADVANCE trial, 1053 PLWH in South Africa were randomised to TAF/FTC/DTG, TDF/FTC/DTG or TDF/FTC/EFV. In both trials, blood pressure was measured at every study visit. Grade 1 hypertension was defined as SBP/DBP >140/90 mmHg. In ADVANCE, all participants developing Grade 1 hypertension were given antihypertensives. In NAMSAL, <1% of participants were given anti-hypertensives, as funding was not available.

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