{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:00:17Z","timestamp":1792000817398,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010877","name":"ViiV Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010877","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009947","name":"Merck Sharp and Dohme United Kingdom","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Most treatment switches are for simplification from three\u2010drug (3DR) to dual regimens (2DR). However, a proportion of people with HIV may switch back to 3DR, like bictegravir\/emtricitabine\/tenofovir alafenamide (B\/F\/TAF) after 2DR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included people with HIV enroled in the Icona cohort who switched to B\/F\/TAF after 2DR INSTI\u2010based (3TC\/DTG, RPV\/DTG, RPV\/CAB, or DOR\u2009+\u2009DTG). Virological rebound (VR), virological suppression (VS), and treatment discontinuation (TD) due to toxicity or failure were evaluated using Kaplan\u2013Meier curves. Random intercept and slopes before and after the switch were used to evaluate the trajectories of triglycerides, cholesterol, CD4, and CD4\/CD8. Viro\u2010immunological analyses were stratified according to HIV\u2010RNA at switch.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 3662 people with HIV who started a 2DR INSTI\u2010based regimen, 71 (1.9%) switched to B\/F\/TAF; 60 had been followed up after the switch, for a median of 10.9\u2009months (interquartile range: 3.6\u201324.7). Forty people with HIV switched with HIV\u2010RNA &lt;50 copies\/mL (uVL), 20 with HIV\u2010RNA \u226550 copies\/mL (dVL). Among the uVL group, one participant experienced VR (HIV\u2010RNA: 99, 71 followed by 29 copies\/mL). Among the dVL group, the 1\u2010year cumulative probability of undetectable VL was 75% (95% confidence interval [CI] 57.6\u201395.1). Fourteen people with HIV interrupted B\/F\/TAF for simplification (50.0%), toxicity (28.6%), VR (14.2%), and patient's choice (7.1); the 1\u2010year cumulative probability of TD for toxicity\/failure was 10.7% (95% CI 14.5\u201324.5). We observed an increase in the CD4\/CD8 ratio (+0.02 CD4\/CD8\/month, <jats:italic>p<\/jats:italic>\u2009=\u20090.026) only in the dVL group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Switching from 2DR\u2010INSTI to B\/F\/TAF is infrequent; this switch results in a low rate of toxicity and failure, along with a favourable immunovirological and lipid profile. CD4\/CD8 gain is observed in those switching with detectable HIV\u2010RNA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.70037","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T03:23:32Z","timestamp":1745897012000},"page":"970-977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Safety and effectiveness of switch to bictegravir\/emtricitabine\/tenofovir alafenamide following dual regimen therapy in people with <scp>HIV<\/scp>: Insights from the Icona cohort"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8265-5400","authenticated-orcid":false,"given":"Andrea","family":"De Vito","sequence":"first","affiliation":[{"name":"Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy University of Sassari  Sassari Italy"},{"name":"PhD School in Biomedical Science, Biomedical Science Department University of Sassari  Sassari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5899-451X","authenticated-orcid":false,"given":"Alessandro","family":"Tavelli","sequence":"additional","affiliation":[{"name":"ICONA Foundation  Milan Italy"},{"name":"National PhD Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6339-919X","authenticated-orcid":false,"given":"Alessandro","family":"Cozzi\u2010Lepri","sequence":"additional","affiliation":[{"name":"Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Giacomelli","sequence":"additional","affiliation":[{"name":"III Infectious Diseases Unit ASST FBF\u2010Sacco  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-8789","authenticated-orcid":false,"given":"Roberto","family":"Rossotti","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases ASST Grande Ospedale Metropolitano Niguarda  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Ponta","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute Vita Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Bobbio","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Galliera Hospital  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ianniello","sequence":"additional","affiliation":[{"name":"Division I of Infectious and Tropical Diseases ASL Citt\u00e0 di Torino  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Cingolani","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Department of Safety and Bioethics Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giordano","family":"Madeddu","sequence":"additional","affiliation":[{"name":"Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy University of Sassari  Sassari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Antinori","sequence":"additional","affiliation":[{"name":"National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0073-1789","authenticated-orcid":false,"given":"Antonella","family":"d'Arminio Monforte","sequence":"additional","affiliation":[{"name":"ICONA Foundation  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ICONA Foundation Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"EACS Guidelines 12.0","author":"EACS European AIDS Clinical Society"},{"key":"e_1_2_11_3_1","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents.Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 2024. 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