{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:14:27Z","timestamp":1790813667825,"version":"4.1.0"},"reference-count":72,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In the last three decades, there has been a considerable improvement in human immunodeficiency virus (HIV) therapy. Acquired immunodeficiency syndrome (AIDS) is no longer a common cause of death for people living with HIV (PLWH) in developed countries, and co-infections with hepatitis viruses can be effectively managed. However, metabolic syndrome and metabolic dysfunction-associated steatotic liver disease (MASLD) are emerging threats these days, especially as the HIV-positive population gets older. The factors for MASLD development in PLWH are numerous, including non-specific (common for both HIV-positive and negative) and virus-specific. We focus on what is known for both, and in particular, on the burden of antiretroviral therapy (ART) for metabolic health and liver damage. We review data on contemporary drugs, including different groups and some particular agents in those groups. Among current ART regimens, the switch from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) and particularly its combination with integrase inhibitors (INSTIs) appear to have the most significant impact on metabolic disturbances by increasing insulin resistance, which over the years promotes the evolution of the cascade leading to metabolic syndrome (MetS), MASLD, and eventually metabolic dysfunction-associated steatohepatitis (MASH).<\/jats:p>","DOI":"10.3390\/v15122432","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T06:53:16Z","timestamp":1702623196000},"page":"2432","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Impact of Combination Antiretroviral Treatment on Liver Metabolic Health in HIV-Infected Persons"],"prefix":"10.3390","volume":"15","author":[{"given":"Micha\u0142","family":"Bia\u0142y","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroc\u0142aw Medical University, 51-149 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Czarnecki","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroc\u0142aw Medical University, 51-149 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Inglot","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroc\u0142aw Medical University, 51-149 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1111\/bcp.12403","article-title":"The Evolution of Three Decades of Antiretroviral Therapy: Challenges, Triumphs and the Promise of the Future: Three Decades of Antiretroviral Therapy","volume":"79","author":"Tseng","year":"2015","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s11904-020-00531-0","article-title":"NASH in HIV","volume":"17","author":"Cervo","year":"2020","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Benedicto, A.M., Fuster-Mart\u00ednez, I., Tosca, J., Esplugues, J.V., Blas-Garc\u00eda, A., and Apostolova, N. (2021). NNRTI and Liver Damage: Evidence of Their Association and the Mechanisms Involved. Cells, 10.","DOI":"10.3390\/cells10071687"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/COH.0000000000000713","article-title":"Lenacapavir: A First-in-Class HIV-1 Capsid Inhibitor","volume":"17","author":"Shaik","year":"2022","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/QAI.0000000000002755","article-title":"Safety and Pharmacokinetics of Once-Daily Multiple-Dose Administration of Islatravir in Adults without HIV","volume":"88","author":"Matthews","year":"2021","journal-title":"JAIDS J. Acquir. Immune Defic. Syndr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Rod\u00e9s, B., Cadi\u00f1anos, J., Esteban-Cantos, A., Rodr\u00edguez-Centeno, J., and Arribas, J.R. (2022). Ageing with HIV: Challenges and Biomarkers. EBioMedicine, 77.","DOI":"10.1016\/j.ebiom.2022.103896"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bavaro, D.F., Laghetti, P., Poliseno, M., De Gennaro, N., Di Gennaro, F., and Saracino, A. (2021). A Step Closer to the \u201cFourth 90\u201d: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV. Diagnostics, 11.","DOI":"10.3390\/diagnostics11112047"},{"key":"ref_8","first-page":"75","article-title":"Fatty Liver Disease in Persons with HIV Infection","volume":"27","author":"Seth","year":"2019","journal-title":"Top. Antivir. Med."},{"key":"ref_9","unstructured":"Allen, A.M., and Talwalkar, J.A. (2018). Zakim and Boyer\u2019s Hepatology, Elsevier."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/COH.0000000000000675","article-title":"Communicable and Noncommunicable Liver Disease in HIV","volume":"16","author":"Mauss","year":"2021","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.1016\/j.jhep.2005.11.004","article-title":"Epidemiology of Viral Hepatitis and HIV Co-Infection","volume":"44","author":"Alter","year":"2006","journal-title":"J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"801","DOI":"10.15585\/mmwr.mm7022a1","article-title":"Estimated Annual Number of HIV Infections\u2014United States, 1981\u20132019","volume":"70","author":"Bosh","year":"2021","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00194-019-0310-x","article-title":"Hepatopathien und Drogenkonsum","volume":"29","year":"2019","journal-title":"Rechtsmedizin"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"104267","DOI":"10.1016\/j.phrs.2019.104267","article-title":"Drug-Induced Liver Steatosis in Patients with HIV Infection","volume":"145","author":"Gervasoni","year":"2019","journal-title":"Pharmacol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2042098620976953","DOI":"10.1177\/2042098620976953","article-title":"Antiretroviral Therapy and Liver Disorders in the OPERA\u00ae Cohort","volume":"11","author":"Wohlfeiler","year":"2020","journal-title":"Ther. Adv. Drug Saf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/0956462416632428","article-title":"Prevalence and Distribution of Non-AIDS Causes of Death among HIV-Infected Individuals Receiving Antiretroviral Therapy: A Systematic Review and Meta-Analysis","volume":"28","author":"Farahani","year":"2017","journal-title":"Int. J. STD AIDS"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/S0140-6736(20)32511-3","article-title":"Non-Alcoholic Fatty Liver Disease","volume":"397","author":"Powell","year":"2021","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2016). EASL\u2013EASD\u2013EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s40121-018-0229-7","article-title":"A Review of Non-Alcoholic Fatty Liver Disease in HIV-Infected Patients: The Next Big Thing?","volume":"8","author":"Mudrikova","year":"2019","journal-title":"Infect. Dis. Ther."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1053\/j.gastro.2018.08.065","article-title":"Epidemiology and Management of Hepatocellular Carcinoma","volume":"156","author":"Kulik","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"International Consensus Panel MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ramai, D., Facciorusso, A., Vigandt, E., Schaf, B., Saadedeen, W., Chauhan, A., di Nunzio, S., Shah, A., Giacomelli, L., and Sacco, R. (2021). Progressive Liver Fibrosis in Non-Alcoholic Fatty Liver Disease. Cells, 10.","DOI":"10.3390\/cells10123401"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.metabol.2018.11.014","article-title":"Obesity and Nonalcoholic Fatty Liver Disease: From Pathophysiology to Therapeutics","volume":"92","author":"Polyzos","year":"2019","journal-title":"Metabolism"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1038\/s41575-021-00448-y","article-title":"The Complex Link between NAFLD and Type 2 Diabetes Mellitus\u2014Mechanisms and Treatments","volume":"18","author":"Targher","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1038\/s41572-020-0181-1","article-title":"HIV and Antiretroviral Therapy-Related Fat Alterations","volume":"6","author":"Koethe","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Park, E., Jeong, J.-J., Won, S.-M., Sharma, S.P., Gebru, Y.A., Ganesan, R., Gupta, H., Suk, K.T., and Kim, D.J. (2021). Gut Microbiota-Related Cellular and Molecular Mechanisms in the Progression of Nonalcoholic Fatty Liver Disease. Cells, 10.","DOI":"10.3390\/cells10102634"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/23744235.2019.1629008","article-title":"Improvement in Liver Steatosis after the Switch from a Ritonavir-Boosted Protease Inhibitor to Raltegravir in HIV-Infected Patients with Non-Alcoholic Fatty Liver Disease","volume":"51","author":"Calza","year":"2019","journal-title":"Infect Dis Lond"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"101116","DOI":"10.1016\/j.eclinm.2021.101116","article-title":"Stratifying the Risk of NAFLD in Patients with HIV under Combination Antiretroviral Therapy (cART)","volume":"40","author":"Bischoff","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"S147","DOI":"10.1097\/QAD.0000000000001483","article-title":"Metabolic Concerns in Aging HIV-Infected Persons: From Serum Lipid Phenotype to Fatty Liver","volume":"31","author":"Guaraldi","year":"2017","journal-title":"AIDS"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1080\/14740338.2019.1644317","article-title":"Metabolic Complications Affecting Adipose Tissue, Lipid and Glucose Metabolism Associated with HIV Antiretroviral Treatment","volume":"18","author":"Lagathu","year":"2019","journal-title":"Expert. Opin. Drug Saf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s11904-017-0351-2","article-title":"Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) in HIV","volume":"14","author":"Rockstroh","year":"2017","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1590\/1806-9282.66.1.81","article-title":"Non-Alcoholic Fatty Liver Disease in Patients Infected with Human Immunodeficiency Virus: A Systematic Review","volume":"66","author":"Pires","year":"2020","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1080\/17474124.2019.1599284","article-title":"Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis in HIV Infection: A Metabolic Approach of an Infectious Disease","volume":"13","author":"Qi","year":"2019","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0140-6736(20)31065-5","article-title":"Emtricitabine and Tenofovir Alafenamide vs. Emtricitabine and Tenofovir Disoproxil Fumarate for HIV Pre-Exposure Prophylaxis (DISCOVER): Primary Results from a Randomised, Double-Blind, Multicentre, Active-Controlled, Phase 3, Non-Inferiority Trial","volume":"396","author":"Mayer","year":"2020","journal-title":"Lancet"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"ofab542","DOI":"10.1093\/ofid\/ofab542","article-title":"Excess Weight Gain With Integrase Inhibitors and Tenofovir Alafenamide: What Is the Mechanism and does It Matter?","volume":"8","author":"Wood","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"758","DOI":"10.7326\/M20-4853","article-title":"Weight and Metabolic Changes after Switching from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in People Living with HIV: A Cohort Study","volume":"174","author":"Surial","year":"2021","journal-title":"Ann. Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"5515","DOI":"10.2147\/DDDT.S274307","article-title":"The Effect of Switching from Tenofovir Disoproxil Fumarate (TDF) to Tenofovir Alafenamide (TAF) on Liver Enzymes, Glucose, and Lipid Profile","volume":"14","author":"Squillace","year":"2020","journal-title":"Drug Des. Dev. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1093\/cid\/ciz999","article-title":"Weight Gain following Initiation of Antiretroviral Therapy: Risk Factors in Randomized Comparative Clinical Trials","volume":"71","author":"Sax","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"ofac538","DOI":"10.1093\/ofid\/ofac538","article-title":"Swiss HIV Cohort Study Factors Associated with Liver Steatosis in People with Human Immunodeficiency Virus on Contemporary Antiretroviral Therapy","volume":"9","author":"Riebensahm","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/QCO.0000000000000616","article-title":"Weight Gain and Integrase Inhibitors","volume":"33","author":"Eckard","year":"2020","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e666","DOI":"10.1016\/S2352-3018(20)30241-1","article-title":"Dolutegravir with Emtricitabine and Tenofovir Alafenamide or Tenofovir Disoproxil Fumarate versus Efavirenz, Emtricitabine, and Tenofovir Disoproxil Fumarate for Initial Treatment of HIV-1 Infection (ADVANCE): Week 96 Results from a Randomised, Phase 3, Non-Inferiority Trial","volume":"7","author":"Venter","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_43","unstructured":"Carbonell Ballesteros, E. (2022). Molecular Mechanisms Involved in the Anti-Inflammatory and Hepatoprotective Effects of the Antiretroviral drug Rilpivirine. [Ph.D. Thesis, Universitat Polit\u00e8cnica de Val\u00e8ncia]."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1038\/s41419-022-04789-7","article-title":"Implication of Autophagy in the Antifibrogenic Effect of Rilpivirine: When More Is Less","volume":"13","author":"Lucantoni","year":"2022","journal-title":"Cell Death Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1016\/S2352-3018(19)30336-4","article-title":"Doravirine versus Ritonavir-Boosted Darunavir in Antiretroviral-Naive Adults with HIV-1 (DRIVE-FORWARD): 96-Week Results of a Randomised, Double-Blind, Non-Inferiority, Phase 3 Trial","volume":"7","author":"Molina","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/COH.0000000000000709","article-title":"Doravirine: Its Role in HIV Treatment","volume":"17","author":"Stockdale","year":"2022","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Mohan, J., Ghazi, T., and Chuturgoon, A.A. (2021). A Critical Review of the Biochemical Mechanisms and Epigenetic Modifications in HIV- and Antiretroviral-Induced Metabolic Syndrome. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222112020"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/jac\/dky507","article-title":"Improvement in Insulin Sensitivity and Serum Leptin Concentration after the Switch from a Ritonavir-Boosted PI to Raltegravir or Dolutegravir in Non-Diabetic HIV-Infected Patients","volume":"74","author":"Calza","year":"2019","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"635089","DOI":"10.3389\/fphar.2021.635089","article-title":"HIV Protease Inhibitors and Insulin Sensitivity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Kajogoo","year":"2021","journal-title":"Front. Pharmacol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1007\/s40265-020-01379-9","article-title":"HIV-1 Integrase Inhibitors: A Comparative Review of Efficacy and Safety","volume":"80","author":"Scarsi","year":"2020","journal-title":"Drugs"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Bai, R., Lv, S., Wu, H., and Dai, L. (2022). Effects of Different Integrase Strand Transfer Inhibitors on Body Weight in Patients with HIV\/AIDS: A Network Meta-Analysis. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07091-1"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"McMahon, C., Trevaskis, J.L., Carter, C., Holsapple, K., White, K., Das, M., Collins, S., Martin, H., and Burns-Naas, L.A. (2020). Lack of an Association between Clinical INSTI-Related Body Weight Gain and Direct Interference with MC4 Receptor (MC4R), a Key Central Regulator of Body Weight. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0229617"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1007\/s40506-019-00203-7","article-title":"Update on Adverse Effects of HIV Integrase Inhibitors","volume":"11","author":"Kolakowska","year":"2019","journal-title":"Curr. Treat. Options Infect. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e811","DOI":"10.1093\/cid\/ciab057","article-title":"Hepatic Steatosis Associated With Exposure to Elvitegravir and Raltegravir","volume":"73","author":"Thomsen","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ejim.2023.01.028","article-title":"Prevalence of Non-Alcoholic Fatty Liver Disease in a Multicentre Cohort of People Living with HIV in Spain","volume":"110","author":"Navarro","year":"2023","journal-title":"Eur. J. Intern. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1093\/cid\/ciz439","article-title":"Cabotegravir Is Not Associated with Weight Gain in Human Immunodeficiency Virus-Uninfected Individuals in HPTN 077","volume":"70","author":"Landovitz","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/QAD.0000000000003085","article-title":"Long-Acting Cabotegravir and Rilpivirine for HIV-1 Suppression: Switch to 2-Monthly Dosing after 5 Years of Daily Oral Therapy","volume":"36","author":"Mills","year":"2022","journal-title":"AIDS"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.trsl.2018.01.004","article-title":"Maraviroc Improves Hepatic Triglyceride Content but Not Inflammation in a Murine Nonalcoholic Fatty Liver Disease Model Induced by a Chronic Exposure to High-Fat Diet","volume":"196","author":"Narro","year":"2018","journal-title":"Transl. Res."},{"key":"ref_59","first-page":"200","article-title":"Maraviroc Modifies Gut Microbiota Composition in a Mouse Model of Obesity: A Plausible Therapeutic Option to Prevent Metabolic Disorders in HIV-Infected Patients","volume":"28","author":"Blanco","year":"2015","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_60","unstructured":"(2023, April 08). Long-Acting Lenacapavir in People with Multidrug-Resistant HIV-1: Week 52 Results. Available online: https:\/\/www.natap.org\/2022\/CROI\/croi_08.htm."},{"key":"ref_61","unstructured":"(2023, April 09). Long-Acting Lenacapavir in a Combination Regimen for Treatment Na\u00c3\u014ave PWH: Week 80. Available online: https:\/\/www.natap.org\/2023\/CROI\/croi_59.htm."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/QAI.0000000000002879","article-title":"Brief Report: Efficacy and Safety of Oral Islatravir Once Daily in Combination With Doravirine Through 96 Weeks for Treatment-Naive Adults With HIV-1 Infection Receiving Initial Treatment With Islatravir, Doravirine, and Lamivudine","volume":"91","author":"Molina","year":"2022","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/COH.0000000000000599","article-title":"Islatravir for the Treatment and Prevention of Infection with the Human Immunodeficiency Virus Type 1","volume":"15","author":"Markowitz","year":"2020","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11908-022-00780-7","article-title":"Novel and Investigational HIV Therapies for Treatment and Prevention: Focus on Cabotegravir, Islatravir, and Lenacapavir","volume":"24","author":"Bernice","year":"2022","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S0140-6736(18)32462-0","article-title":"Dolutegravir plus Lamivudine versus Dolutegravir plus Tenofovir Disoproxil Fumarate and Emtricitabine in Antiretroviral-Naive Adults with HIV-1 Infection (GEMINI-1 and GEMINI-2): Week 48 Results from Two Multicentre, Double-Blind, Randomised, Non-Inferiority, Phase 3 Trials","volume":"393","author":"Cahn","year":"2019","journal-title":"Lancet"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/QAI.0000000000001344","article-title":"Brief Report: Long-Term (96-Week) Efficacy and Safety After Switching From Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in HIV-Infected, Virologically Suppressed Adults","volume":"75","author":"Raffi","year":"2017","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e195","DOI":"10.1016\/S2352-3018(17)30031-0","article-title":"Switching from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide Coformulated with Rilpivirine and Emtricitabine in Virally Suppressed Adults with HIV-1 Infection: A Randomised, Double-Blind, Multicentre, Phase 3b, Non-Inferiority Study","volume":"4","author":"Orkin","year":"2017","journal-title":"Lancet HIV"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1097\/QAD.0000000000000169","article-title":"Week 48 Results from a Randomized Clinical Trial of Rilpivirine\/Emtricitabine\/Tenofovir Disoproxil Fumarate vs. Efavirenz\/Emtricitabine\/Tenofovir Disoproxil Fumarate in Treatment-Naive HIV-1-Infected Adults","volume":"28","author":"Cohen","year":"2014","journal-title":"AIDS"},{"key":"ref_69","unstructured":"Center for Drug Evaluation and Research (2023, March 15). Human Immunodeficiency Virus-1 Infection: Developing Antiretroviral Drugs for Treatment, Available online: https:\/\/www.fda.gov\/regulatory-information\/search-fda-guidance-documents\/human-immunodeficiency-virus-1-infection-developing-antiretroviral-drugs-treatment."},{"key":"ref_70","unstructured":"(2023, April 09). EACS Guidelines 2022. Available online: https:\/\/eacs.sanfordguide.com."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s11904-019-00467-0","article-title":"Contemporary Lifestyle Modification Interventions to Improve Metabolic Comorbidities in HIV","volume":"16","author":"Fitch","year":"2019","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1177\/1756283X16638830","article-title":"Lifestyle Changes for the Treatment of Nonalcoholic Fatty Liver Disease: A Review of Observational Studies and Intervention Trials","volume":"9","author":"Godos","year":"2016","journal-title":"Ther. Adv. Gastroenterol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/12\/2432\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:39:11Z","timestamp":1760132351000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/12\/2432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":72,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["v15122432"],"URL":"https:\/\/doi.org\/10.3390\/v15122432","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]}}}