Biktarvy could be long-term option for older adults with HIV

The most common adverse events (AEs) of BIC/FTC/TAF have been nausea, diarrhea and headache. In this study, two people reported a grade 3 AE and none reported a grade 4 event.

In addition, patients maintained viral suppression without it affecting weight or kidney function; some saw their lipid levels drop from baseline to week 96 with a 19% reduction in fasting triglycerides and a 0.2% reduction in total cholesterol to high-density lipoprotein ratio.

“In my experience with older patients with HIV, it is rare that I have had someone who cannot tolerate it when switched,” said Judith Aberg, MD, the chief of the Division of Infectious Disease for the Icahn School of Medicine at Mount Sinai and Mount Sinai Health System, in New York City, because it was already found to be effective and well tolerated in this age group through 48 weeks (Infect Dis Ther 2021;10[2]:775-788). “I was surprised that almost 13% experienced treatment-emergent adverse events in this small study, as we usually see this more often when you start a regimen, rather than when you switch.”

Yet, the AEs “are not surprising for an older adult population,” said Kristine Erlandson, MD, an associate professor of medicine and epidemiology at the University of Colorado Anschutz Medical Campus, in Aurora. “Distinguishing adverse effects due to medication versus new events that are more common with aging becomes a bit more challenging in this older population,” she said. She cited sleep disturbances as a common issue among older adults, “particularly over the long duration of follow-up in this study,” she said.

Dr. Erlandson also noted that questions about weight gain with this regimen were not clearly answered in this study population with limited racial/ethnic and gender diversity. However, she appreciated the study’s focus on older adults.

“I commend the authors for focusing on this older adult population who is often excluded from clinical trials.”

This study “adds a little bit, but not much” to existing research about HIV medications, but more studies that compare one regimen to another are needed, Dr. Aberg said.

In 2018, more than 50% of Americans diagnosed with HIV were at least 50 years old. “By 2030, more than 80% of people living with HIV will have at least one age-related medical condition, such as cancer or heart disease,” Dr. Gallant said. “The burdens of HIV, aging and related health comorbidities necessitate a focus on improving long-term health and quality of life.”

By Cheryl Alkon