Metabolic impact of switching from EFV/TDF/FTC to two INSTI-Based regimens (B/F/TAF vs. DTG/3TC): a real-world study in virologically suppressed individuals

Objective: To compare metabolic outcomes in virologically suppressed PLWH switching from EFV/TDF/3TC to either B/F/TAF or DTG/3TC. Methods: In this retrospective real-world study of 326 patients, weight, lipid (TG, TC), glucose (GLU), and uric acid (SUA) changes were assessed over 24 months. Generalized linear mixed models and logistic regression identified factors associated with metabolic trends and clinically significant weight gain (>5%). Results: = 0.008). These findings remained consistent in participants with hypertension. Conclusion: In virologically suppressed PLWH, switching to B/F/TAF or DTG/3TC provides comparable metabolic safety profiles. Clinical management should prioritize individualized regimen selection alongside proactive management of traditional metabolic risk factors.