Abstract: SA-PO1223
Impact of Tenofovir Alafenamide (TAF)-Containing Regimens vs. Regimens Without TAF on Kidney Outcomes in HIV Treatment: Systematic Literature Review and Meta-Analysis
Session Information
- CKD: Biomarkers and Emerging Tools for Diagnosis and Monitoring
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Liu, Haopeng, University of Utah Health, Salt Lake City, Utah, United States
- Teali, Ishfaq Rashid, University of Utah Health, Salt Lake City, Utah, United States
- Rashid, Muhammed, University of Utah Health, Salt Lake City, Utah, United States
- Kalati, Java, University of Utah Health, Salt Lake City, Utah, United States
- Willis, Connor W., University of Utah Health, Salt Lake City, Utah, United States
- Rogers, Rachel, Gilead Sciences Inc, Foster City, California, United States
- Navadeh, Soodi, Gilead Sciences Inc, Foster City, California, United States
- Weinberg, Amy R., Gilead Sciences Inc, Foster City, California, United States
- Chaiyakunapruk, Nathorn, University of Utah Health, Salt Lake City, Utah, United States
Background
Tenofovir disoproxil has been linked to renal adverse events. TAF, a prodrug of tenofovir (TFV), shows improved renal outcomes. Further analyses are needed to compare renal outcomes between TAF and other antiretroviral therapies (ART).
Methods
A comprehensive search in multiple databases was done up to 02/14/2025. Eligible studies were randomized controlled trials (RCTs) comparing TAF vs non-TAF ART for HIV-1 treatment and reported changes in estimated glomerular filtration rate (eGFR) or serum creatinine (SCr). Outcomes were pooled by mean difference (MD) and 95% confidence intervals (95% CI) in random-effects models.
Results
We included 22 RCTs for eGFR (11,160 patients) and 18 for SCr (9,785 patients). Compared to non-TAF ART, TAF was associated with increased eGFR (MD: 1.40 mL/min; 95% CI: 0.72 to 2.07; I2 = 94.9%, Figure 1A) and decreased SCr (MD: -0.01 mg/dL; 95% CI: -0.03 to 0.01; I2 = 92.1%). In subgroup analyses compared with non-TFV ART, TAF showed similar trends (eGFR: MD: 1.82 mL/min; 95% CI: -0.40 to 4.04; I2 = 86%, Figure 1B; SCr: MD: -0.01 mg/dL; 95% CI: -0.03 to 0.01; I2 = 87%), with increased eGFR effect over time (Table 1).
Conclusion
Our findings demonstrated potential renal safety advantages of TAF over both non-TAF and TFV-sparing ART for HIV-1 treatment.
Changes of eGFR in TAF vs Non-TFV Over Time
| Follow-up at: | Number of studies | TAF regimens | Non-TFV regimens | Effect sizes (95% CI) | I^2, % |
| 24 weeks | 2 | 196 | 118 | -3.03 (-11.17 to 5.11) | 78.1 |
| 48 weeks | 7 | 1369 | 1440 | 2.50 (1.55 to 3.44) | 6.9 |
| 96 weeks | 2 | 588 | 586 | 3.29 (0.66 to 5.92) | 68.82 |
| 144 weeks | 1 | 315 | 294 | 5.30 (3.85 to 6.75) | -* |
*Heterogeneity unavailable as only one study at 144 weeks
SD for standard deviation.
Funding
- Commercial Support – Gilead Sciences, Inc.