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Practice Question of the Week
November 27, 2023: HIV 101: Antiretroviral Therapy Maintenance and Risk of Weight Gain
A 35-year-old White man has been on efavirenz (EFV)/emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) for the past 10 years. He has been very reluctant to change a regimen that “saved his life.” However, because of persistent insomnia and depressive disorder, he is willing to consider a change. His CD4+ count is 700 cells/µL and his HIV RNA level is less than 20 copies/mL. Which of the following weight changes might result from a switch to bictegravir (BIC)/FTC/tenofovir alafenamide fumarate (TAF)?
A. No change in weight, as the patient was already virologically suppressed
B. Weight loss, given that TAF is associated with fewer metabolic complications
C. Weight gain because of the switch from TDF to TAF
D. Weight gain because of the switch from EFV to BIC
E. Both C and D
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