Impact of tenofovir on SARS-CoV-2 infection and severe outcomes among people living with HIV: a propensity score-matched study
Authors: Nomah Daniel K , Reyes-Urueña Juliana , Díaz Yesika , Moreno Sergio , Aceiton Jordi , Bruguera Andreu , Vivanco-Hidalgo Rosa M , Casabona Jordi , Domingo Pere , Navarro Jordi , Imaz Arkaitz , Deig Elisabet , Navarro Gemma , Llibre Josep M , Miro Jose M ,   PISCIS study group, Muntada Esteve , Esteve Anna , Fanjul Francisco , Falcó Vicenç , Knobel Hernando , Mallolas Josep , Tiraboschi Juan , Curran Adrià , Burgos Joaquín , Revollo Boris , Gracia Maria , del Mar Gutierrez Maria , Murillas Javier , Homar Francisco , Fernández-Montero Jose V , González Eva , Peraire Joaquim , Force Lluís , Leon Elena , Hortos Miquel , Vilaró Ingrid , Orti Amat , Dalmau David , Jaen Àngels , De Lazzari Elisa , Berrocal Leire , Rodríguez Lucía , Gargoulas Freya , Vanrell Toni , Carlos Jose , Vilà Josep , Martínez Marina , Morell Bibiana , Tamayo Maribel , Palacio Jorge , Ambrosioni Juan , Laguno Montse , Martínez-Rebollar María , Blanco José L , Garcia Felipe , Torres Berta , de la Mora Lorena , Inciarte Alexy , Ugarte Ainoa , Chivite Iván , González-Cordon Ana , Leal Lorna , Jou Antoni , Negredo Eugènia , Saumoy Maria , Silva Ana , Scévola Sofia , Suanzes Paula , Alvarez Patricia , Mur Isabel , Jaume Melchor Riera , García-Gasalla Mercedes , Ribas Maria À , Campins Antoni A , Peñaranda María , Martin María L , Haydee Helem , Calzado Sònia , Cervantes Manel , Navarro Marta , Payeras Antoni , Cifuentes Carmen , Villoslada Aroa , Sorní Patrícia , Molero Marta , Abdulghani Nadia , Comella Thaïs , Sola Rocio , Vargas Montserrat , Viladés Consuleo , Martí Anna , Yeregui Elena , Rull Anna , Barrufet Pilar , Arbones Laia , Chamarro Elena , Escrig Cristina , Cairó Mireia , Martinez-Lacasa Xavier , Font Roser , Macorigh Lizza , Hernández Juanse 
Published: June 2022

Abstract

Background
Reports on the impact of some antiretrovirals against SARS-CoV-2 infection and disease severity are conflicting.

Objectives
We evaluated the effect of tenofovir as either tenofovir alafenamide/emtricitabine (TAF/FTC) or tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) against SARS-CoV-2 infection and associated clinical outcomes among people living with HIV (PLWH).

Methods
We conducted a propensity score-matched analysis in the prospective PISCIS cohort of PLWH (n = 14 978) in Catalonia, Spain. We used adjusted Cox regression models to assess the association between tenofovir and SARS-CoV-2 outcomes.

Results
After propensity score-matching, SARS-CoV-2 diagnosis rates were similar in TAF/FTC versus ABC/3TC recipients (11.6% versus 12.5%, P = 0.256); lower among TDF/FTC versus ABC/3TC recipients (9.6% versus 12.8%, P = 0.021); and lower among TDF/FTC versus TAF/FTC recipients (9.6% versus 12.1%, P = 0.012). In well-adjusted logistic regression models, TAF/FTC was no longer associated with reduced SARS-CoV-2 diagnosis [adjusted odds ratio (aOR) 0.90; 95% confidence interval (CI), 0.78–1.04] or hospitalization (aOR 0.93; 95% CI, 0.60–1.43). When compared with ABC/3TC, TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.79; 95% CI, 0.60–1.04) or hospitalization (aOR 0.51; 95% CI, 0.15–1.70). TDF/FTC was not associated with reduced SARS-CoV-2 diagnosis (aOR 0.79; 95% CI, 0.60–1.04) or associated hospitalization (aOR 0.33; 95% CI, 0.10–1.07) compared with TAF/FTC.

Conclusions
TAF/FTC or TDF/FTC were not associated with reduced SARS-CoV-2 diagnosis rates or associated hospitalizations among PLWH. TDF/FTC users had baseline characteristics intrinsically associated with more benign SARS-CoV-2 infection outcomes. Tenofovir exposure should not modify any preventive or therapeutic SARS-CoV-2 infection management.