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Hypertension, Statin Use Increased for Individuals Using TAF for PrEP

Incident hypertension, statin use higher with tenofovir alafenamide fumarate compared with tenofovir disoproxil fumarate

By Elana Gotkine HealthDay Reporter

THURSDAY, Sept. 14, 2023 (HealthDay News) — For individuals taking preexposure prophylaxis (PrEP) for preventing HIV infection, tenofovir alafenamide fumarate (TAF) use is associated with higher incident hypertension and statin initiation compared with tenofovir disoproxil fumarate (TDF) use, according to a study published online Sept. 11 in JAMA Network Open.

Adovich S. Rivera, M.D., Ph.D., from Kaiser Permanente Southern California in Pasadena, and colleagues examined the risk for incident hypertension and statin initiation among adult health plan members initiating PrEP with TAF versus TDF in a retrospective cohort study. Propensity score matching was conducted to generate matched data sets (1:4 TAF:TDF) with balanced baseline covariates.

Data were included for 6,824 eligible individuals. Two cohorts were generated without baseline hypertension or statin use for matching: 5,523 for hypertension and 6,149 for statin. The researchers found that in a matched analysis adjusted for baseline covariates, the risk for incident hypertension was elevated in association with TAF use (odds ratio, 1.64). An elevated risk for statin initiation was also seen in association with TAF use (odds ratio, 2.33). Similar results with a larger risk difference in statin initiation were seen in a subgroup analysis restricted to individuals aged 40 years and older at PrEP initiation (odds ratio, 3.05).

“TAF has been a welcome addition to the products for PrEP due to its benefits on kidney and bone health and smaller pill size,” the authors write. “However, it may have unwanted impact on cardiometabolic health.”

Two authors disclosed ties to the pharmaceutical industry.

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