{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:08:43Z","timestamp":1785434923518,"version":"3.56.0"},"reference-count":53,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead Sciences","award":["19623"],"award-info":[{"award-number":["19623"]}]},{"award":["19623"],"award-info":[{"award-number":["19623"]}],"id":[{"id":"https:\/\/ror.org\/03hxqcn24","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Long-term real-world data on bictegravir\/emtricitabine\/tenofovir alafenamide (BIC-STR), particularly in key subgroups, remain limited. The primary endpoints of the study were changes in CD4+ cell count and viral load after BIC-STR introduction. The secondary endpoints were the impact of the therapy on metabolic profile and body mass index. Methods: Retrospective observational cohort study including people living with HIV (PLWH) receiving BIC-STR with more than 6 months of follow-up at a tertiary Infectious Diseases clinic (Perugia, Italy). Immunovirological outcomes (HIV-RNA, CD4 count, CD4\/CD8 ratio) and metabolic parameters were assessed up to 48 months, with subgroup analyses (treatment-na\u00efve\/experienced, &gt;60 years, women, and foreign nationals). Results: 425 patients were included (median follow-up 37.7 months, IQR, 22.1\u201355.8 months). Most were treatment-experienced (367\/425, 86.4%) and viral suppression improved after switching, reaching 90.7% with HIV-RNA &lt; 50 cp\/mL; HIV-RNA declined mainly within the first 6 months and then remained stable. CD4 count and CD4\/CD8 ratio increased significantly over time, with similar immunovirological trends in older patients (&gt;60 years; 138\/425, 32.3%), women (94\/425, 22.1%), and foreign nationals (143\/425, 33.7%). In treatment-experienced patients not on statins, HDL and LDL did not change significantly, while triglycerides decreased (median from 110 mg\/dL, IQR 78.0\u2013164.0, to 103 mg\/dL, IQR 70.3\u2013147.8; p = 0.007). In ART-na\u00efve patients (58\/425, 13.6%), HDL (median from 41, IQR, 33.0\u201347.0 to 47, IQR 39.0\u201354.7, p = 0.0003) and BMI (median from 23.2, IQR 21.7\u201326.3 to 25.7, IQR 23.4\u201329.0, p &lt; 0.0001) increased, whereas other lipid changes were not significant. BMI increased only in underweight and normal-weight na\u00efve patients, not in overweight\/obese individuals. Conclusions: BIC-STR showed sustained effectiveness, immunological benefit, and favourable metabolic outcomes in routine practice, including, PLWH &gt; 60 years, women, and foreign nationals subgroups.<\/jats:p>","DOI":"10.3390\/jcm15145553","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T03:34:23Z","timestamp":1784172863000},"page":"5553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bictegravir\/Tenofovir Alafenamide\/Emtricitabine in Real-Life: A Multi-Year Experience"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6556-6553","authenticated-orcid":false,"given":"Anna","family":"Gidari","sequence":"first","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Baranello","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0355-2885","authenticated-orcid":false,"given":"Carlo","family":"Pallotto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Morosi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Papalini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Gamboni","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Malincarne","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Rosignoli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Carolina","family":"Benvenuto","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Gonnelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5866-3849","authenticated-orcid":false,"given":"Claudio","family":"Ucciferri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8774-4843","authenticated-orcid":false,"given":"Giuseppe Vittorio De","family":"Socio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Clinic of Infectious Diseases, \u201cSanta Maria Della Misericordia\u201d Hospital, University of Perugia, 06132 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"ref_1","first-page":"S43","article-title":"HIV Symposium","volume":"112","author":"Ahonkhai","year":"2020","journal-title":"J. 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