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<p>Daily oral pre-exposure prophylaxis (PrEP), including emtricitabine/tenofovir disoproxil fumarate (TDF) and emtricitabine/tenofovir alafenamide fumarate (TAF), is a key strategy for HIV prevention. Compared to TDF-based PrEP, TAF may be associated with greater weight gain. This study aims to examine the risk of weight gain among cisgender men and transgender women who were adults and took TAF for HIV prevention using real-world data. This study used data from All of Us, a nationwide research initiative designed to accelerate health and medical discoveries. All PrEP users in All of Us with at least two weight measures, one taken within 180 days prior to and the other between 90 and 365 days after initiating PrEP, were included in analyses. Linear regression was conducted to explore the association between different PrEP regimens and weight gain, adjusting for key sociodemographic characteristics. Among 385 eligible individuals, 284 were TDF-only users, 52 were TAF-only users, and 49 individuals switched from TDF to TAF. The median follow-up time for participants was 312 days. The average weight gain (in kilograms) for TDF-only, TAF-only, and TDF-TAD groups was − 0.68 (standard deviation [SD] = 5.43), 1.80 (SD = 11.60), and 1.74 (SD = 6.35), respectively. TAF-only (β = 2.532, 95%CI 0.708–4.356) and TDF-TAF (β = 2.756, 95%CI 0.890–4.621) were associated with significantly increased weight gain compared to TDF-only use. Closer monitoring of weight gain is recommended for individuals using TAF to prevent HIV.</p>

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Tenofovir alafenamide fumarate use for HIV pre-exposure prophylaxis and weight gain

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月17日

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  • Fanghui Shi,
  • Huiyi Xia,
  • Sharon Weissman,
  • Xiaoming Li,
  • Xueying Yang

摘要

Daily oral pre-exposure prophylaxis (PrEP), including emtricitabine/tenofovir disoproxil fumarate (TDF) and emtricitabine/tenofovir alafenamide fumarate (TAF), is a key strategy for HIV prevention. Compared to TDF-based PrEP, TAF may be associated with greater weight gain. This study aims to examine the risk of weight gain among cisgender men and transgender women who were adults and took TAF for HIV prevention using real-world data. This study used data from All of Us, a nationwide research initiative designed to accelerate health and medical discoveries. All PrEP users in All of Us with at least two weight measures, one taken within 180 days prior to and the other between 90 and 365 days after initiating PrEP, were included in analyses. Linear regression was conducted to explore the association between different PrEP regimens and weight gain, adjusting for key sociodemographic characteristics. Among 385 eligible individuals, 284 were TDF-only users, 52 were TAF-only users, and 49 individuals switched from TDF to TAF. The median follow-up time for participants was 312 days. The average weight gain (in kilograms) for TDF-only, TAF-only, and TDF-TAD groups was − 0.68 (standard deviation [SD] = 5.43), 1.80 (SD = 11.60), and 1.74 (SD = 6.35), respectively. TAF-only (β = 2.532, 95%CI 0.708–4.356) and TDF-TAF (β = 2.756, 95%CI 0.890–4.621) were associated with significantly increased weight gain compared to TDF-only use. Closer monitoring of weight gain is recommended for individuals using TAF to prevent HIV.