{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:43:10Z","timestamp":1770748990822,"version":"3.50.0"},"reference-count":47,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gilead"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Background: Antiretroviral therapy has transformed HIV infection from a fatal disease to a chronic and manageable condition, but increasing health issues beyond acquired immunodeficiency syndrome, such as metabolic, liver, and cardiovascular diseases, have been observed. Furthermore, the increasing prevalence of HIV strains resistant to older antiretroviral regimens has necessitated a re-evaluation of treatment strategies. Methods: We performed a retrospective, observational study to evaluate the long-term outcomes of an antiretroviral switch from a non-nucleoside reverse transcriptase inhibitor-based to bictegravir-based regimen; this study aimed to assess the impact of this antiretroviral switch on treatment adherence, the safety profile, and virologic outcomes. The secondary objectives were to analyze the changes in lipid, kidney function, liver function, and anthropometric parameters after switching. Results: A total of 25 patients were included in this analysis; virologic suppression was maintained over time, with 100% of patients demonstrating undetectable viral loads at 6, 12, 24, and 36 months. In parallel, a significant increase in CD4+ cell count was observed after switching. No significant differences were observed compared to the previous therapy regarding anthropometric parameters or laboratory parameters. However, a significant reduction in liver steatosis, as assessed by Fibroscan, was observed. Conclusions: bictegravir-based regimens are a valid therapeutic option for people living with HIV, particularly for those with metabolic comorbidities.<\/jats:p>","DOI":"10.3390\/v17030440","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:48:37Z","timestamp":1742370517000},"page":"440","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Switching to Bictegravir\/Emtricitabine\/Tenofovir Alafenamide Fumarate Regimen and Its Effect on Liver Steatosis Assessed by Fibroscan"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8105-5139","authenticated-orcid":false,"given":"Marcello","family":"Trizzino","sequence":"first","affiliation":[{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Gaudiano","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dalila Mim\u00ec","family":"Arena","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1871-4285","authenticated-orcid":false,"given":"Luca","family":"Pipit\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d, University of Palermo, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Gio\u00e8","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1992-1796","authenticated-orcid":false,"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Infectious and Tropical Disease Unit and Sicilian Regional Reference Center for the Fight Against AIDS, AOU Policlinico \u201cP. Giaccone\u201d, 90127 Palermo, Italy"},{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties \u201cG. D\u2019Alessandro\u201d, University of Palermo, 90127 Palermo, Italy"},{"name":"Palermo Fast-Track City, Casa dei Diritti, Via Libert\u00e0 45, 90143 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e92","DOI":"10.1016\/S2352-3018(15)00017-X","article-title":"AIDS incidence and AIDS-related mortality in British Columbia, Canada, between 1981 and 2013: A retrospective study","volume":"2","author":"Lima","year":"2015","journal-title":"Lancet HIV"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1097\/QAI.0000000000003039","article-title":"The Effect of Pretreatment Potential Resistance to NNRTIs on Antiviral Therapy in Patients with HIV\/AIDS","volume":"91","author":"Li","year":"2022","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2174\/187152611795589663","article-title":"HIV treatment adherence, drug resistance, virologic failure: Evolving concepts","volume":"11","author":"Nachega","year":"2011","journal-title":"Infect. Disord.-Drug Targets"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"115862","DOI":"10.1016\/j.bcp.2023.115862","article-title":"Biktarvy for the treatment of HIV infection: Progress and prospects","volume":"217","author":"Zhang","year":"2023","journal-title":"Biochem. Pharmacol."},{"key":"ref_5","first-page":"68","article-title":"Next-generation sequencing and drug resistance mutations of HIV-1 subtypes in people living with HIV in Sicily, Italy, 2021\u20132023","volume":"41","author":"Trizzino","year":"2024","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/cid\/ciw650","article-title":"Suboptimal Adherence to Combination Antiretroviral Therapy Is Associated with Higher Levels of Inflammation Despite HIV Suppression","volume":"63","author":"Brown","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S375","DOI":"10.1093\/infdis\/jis200","article-title":"Immunologic basis of cardiovascular disease in HIV-infected adults","volume":"205","author":"Hsue","year":"2012","journal-title":"J. Infect. Dis."},{"key":"ref_8","first-page":"e36755","article-title":"A Systematic Review Exploring the Range of Renal Complications of Human Immunodeficiency Virus","volume":"15","author":"Yussuf","year":"2023","journal-title":"Cureus"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/S1474-4422(14)70137-1","article-title":"Controversies in HIV-associated neurocognitive disorders","volume":"13","author":"Nightingale","year":"2014","journal-title":"Lancet Neurol."},{"key":"ref_10","first-page":"158","article-title":"Weight gain in HIV-infected individuals using distinct antiretroviral drugs","volume":"22","year":"2020","journal-title":"AIDS Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1111\/hiv.13697","article-title":"Metabolic dysfunction-associated steatohepatitis exhibits sex differences in people with HIV","volume":"25","author":"Kablawi","year":"2024","journal-title":"HIV Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1016\/j.jhep.2024.06.026","article-title":"Inclusive healthcare in light of the new MASLD guidelines: Should people living with HIV be screened for liver fibrosis?","volume":"82","author":"Sebastiani","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_13","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_14","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1007\/s10461-022-03880-6","article-title":"Interactions of Antiretroviral Drugs with Food, Beverages, Dietary Supplements, and Alcohol: A Systematic Review and Meta-analyses","volume":"27","author":"Wiesner","year":"2023","journal-title":"AIDS Behav."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"512","DOI":"10.18683\/germs.2021.1286","article-title":"Treatment initiation or switch to BIC\/FTC\/TAF-real-world safety and efficacy data from two HIV centers in Romania","volume":"11","author":"Irimia","year":"2021","journal-title":"Germs"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"ofae630","DOI":"10.1093\/ofid\/ofae630","article-title":"Effectiveness and Safety of Bictegravir\/Emtricitabine\/Tenofovir Alafenamide in Late-Presenting People with HIV-1 Infection","volume":"11","author":"Yang","year":"2024","journal-title":"Open Forum Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S530","DOI":"10.1093\/ofid\/ofaa439.1189","article-title":"BIC\/FTC\/TAF Maintains Viral Suppression in Patients with Documented M184V\/I Mutations: A Real World Experience","volume":"7","author":"Chamberlain","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_18","first-page":"87","article-title":"Clinical perspective on drug-drug interactions with the non-nucleoside reverse transcriptase inhibitor rilpivirine","volume":"15","author":"Crauwels","year":"2013","journal-title":"AIDS Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1177\/0091270004269142","article-title":"Induction of CYP3A4 by efavirenz in primary human hepatocytes: Comparison with rifampin and phenobarbital","volume":"44","author":"Hariparsad","year":"2004","journal-title":"J. Clin. Pharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1080\/15284336.2015.1112480","article-title":"Improvement of lipid profiles when switching from efavirenz to rilpivirine in HIV-infected patients with dyslipidemia","volume":"17","author":"Thamrongwonglert","year":"2016","journal-title":"HIV Clin. Trials"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1586\/14787210.2016.1157469","article-title":"A review of trials investigating efavirenz-induced neuropsychiatric side effects and the implications","volume":"14","author":"Gaida","year":"2016","journal-title":"Expert Rev. Anti. Infect. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3851\/IMP3346","article-title":"The effect of tenofovir disoproxil fumarate on bone mineral density: A systematic review and meta-analysis","volume":"25","author":"Baranek","year":"2020","journal-title":"Antivir. Ther."},{"key":"ref_23","first-page":"e45787","article-title":"Tenofovir-Induced Renal Dysfunction Among HIV-Infected Patients: A Systematic Review","volume":"15","author":"Shivakumar","year":"2023","journal-title":"Cureus"},{"key":"ref_24","first-page":"44","article-title":"Once-Daily, Single-Tablet Regimens For the Treatment of HIV-1 Infection","volume":"40","author":"Truong","year":"2015","journal-title":"Pharm. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/cid\/cit637","article-title":"The Quad Pill, a Once-Daily Combination Therapy for HIV Infection","volume":"58","author":"Johnson","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"23259582221140208","DOI":"10.1177\/23259582221140208","article-title":"Real World Data on Forgiveness to Uncomplete Adherence to Bictegravir\/ Emtricitabine\/Tenofovir Alafenamide","volume":"21","author":"Maggiolo","year":"2022","journal-title":"J. Int. Assoc. Provid. AIDS Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/sextrans-2024-056202","article-title":"B\/F\/TAF forgiveness to non-adherence","volume":"100","author":"Maggiolo","year":"2024","journal-title":"Sex Transm. Infect."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106898","DOI":"10.1016\/j.phrs.2023.106898","article-title":"Pillars of long-term antiretroviral therapy success","volume":"196","author":"Taramasso","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Colpani, A., De Vito, A., Marino, A., Ceccarelli, M., Celesia, B.M., Conti, G.N., Spampinato, S., Moi, G., Venanzi Rullo, E., and Pellican\u00f2, G.F. (2024). Viro-Immunological Efficacy and Safety of Bictegravir\/Emtricitabine\/Tenofovir Alafenamide among Women Living with HIV: A 96-Week Post-Switch Analysis from the Real-Life SHiNe-SHiC Cohort. Biomedicines, 12.","DOI":"10.3390\/biomedicines12102311"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e389","DOI":"10.1016\/S2352-3018(20)30099-0","article-title":"Fixed-dose combination bictegravir, emtricitabine, and tenofovir alafenamide versus dolutegravir-containing regimens for initial treatment of HIV-1 infection: Week 144 results from two randomised, double-blind, multicentre, phase 3, non-inferiority trials","volume":"7","author":"Orkin","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lazzaro, A., Cacciola, E.G., Borrazzo, C., Innocenti, G.P., Cavallari, E.N., Mezzaroma, I., Falciano, M., Fimiani, C., Mastroianni, C.M., and Ceccarelli, G. (2021). Switching to a Bictegravir Single Tablet Regimen in Elderly People Living with HIV-1: Data Analysis from the BICTEL Cohort. Diagnostics, 12.","DOI":"10.3390\/diagnostics12010076"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"16785","DOI":"10.1038\/s41598-024-67837-6","article-title":"Relationship between adherence to bictegravir\/emtricitabine\/tenofovir alafenamide fumarate and clinical outcomes in people with HIV in Japan: A claims database analysis","volume":"14","author":"Taguchi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1093\/jac\/dkae081","article-title":"Long-term outcomes of bictegravir\/emtricitabine\/tenofovir alafenamide as first-line therapy and as switch strategy in virologically suppressed persons with HIV: Data from the ICONA cohort","volume":"79","author":"Tavelli","year":"2024","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1002\/hep4.1958","article-title":"Effect of hepatic steatosis and associated metabolic comorbidities on health-related quality of life in people living with HIV","volume":"6","author":"Michel","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Oeda, S., Tanaka, K., Oshima, A., Matsumoto, Y., Sueoka, E., and Takahashi, H. (2020). Diagnostic Accuracy of FibroScan and Factors Affecting Measurements. Diagnostics, 10.","DOI":"10.3390\/diagnostics10110940"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/S0140-6736(24)01811-7","article-title":"Steatotic liver disease","volume":"404","author":"Israelsen","year":"2024","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1111\/hiv.13274","article-title":"Dangerous liaisons: NAFLD and liver fibrosis increase cardiovascular risk in HIV","volume":"23","author":"Cervo","year":"2022","journal-title":"HIV Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.14309\/ajg.0000000000002700","article-title":"Diagnostic Ability of Simple Noninvasive Blood Tests to Predict Increased Liver Stiffness in People Living With HIV and Steatotic Liver Disease","volume":"119","author":"Sterling","year":"2024","journal-title":"Am. J. Gastroenterol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/hiv.12799","article-title":"Application of guidelines for the management of nonalcoholic fatty liver disease in three prospective cohorts of HIV-monoinfected patients","volume":"21","author":"Sebastiani","year":"2020","journal-title":"HIV Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1002\/hep4.1411","article-title":"Impact of Implementing a \u201cFIB-4 First\u201d Strategy on a Pathway for Patients with NAFLD Referred from Primary Care","volume":"3","author":"Davyduke","year":"2019","journal-title":"Hepatol. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1016\/j.asjsur.2024.03.004","article-title":"TyG index is positively associated with HOMA-IR in cholelithiasis patients with insulin resistance: Based on a retrospective observational study","volume":"47","author":"Ozturk","year":"2024","journal-title":"Asian J. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5049","DOI":"10.2147\/IDR.S493140","article-title":"Association Between TyG Index, Liver Steatosis and Immunosenescence in People Living with HIV","volume":"17","author":"Yan","year":"2024","journal-title":"Infect. Drug Resist."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Sapu\u0142a, M., Suchacz, M., Za\u0142\u0119ski, A., and Wierci\u0144ska-Drapa\u0142o, A. (2022). Impact of Combined Antiretroviral Therapy on Metabolic Syndrome Components in Adult People Living with HIV: A Literature Review. Viruses, 14.","DOI":"10.3390\/v14010122"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/hiv.13644","article-title":"Improvement in insulin sensitivity after switching from an integrase inhibitor-based regimen to doravirine\/tenofovir disoproxil fumarate\/lamivudine in people with significant weight gain","volume":"25","author":"Calza","year":"2024","journal-title":"HIV Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1148\/radiol.2021204288","article-title":"Quantification of Liver Fat Content with CT and MRI: State of the Art","volume":"301","author":"Starekova","year":"2021","journal-title":"Radiology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"774079","DOI":"10.3389\/fmed.2021.774079","article-title":"MAFLD\/NAFLD Biopsy-Free Scoring Systems for Hepatic Steatosis, NASH, and Fibrosis Diagnosis","volume":"8","year":"2022","journal-title":"Front. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.cld.2017.08.006","article-title":"The Use of Liver Biopsy in Nonalcoholic Fatty Liver Disease: When to Biopsy and in Whom","volume":"22","author":"Gunn","year":"2018","journal-title":"Clin. Liver Dis."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/3\/440\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:56:31Z","timestamp":1760028991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/3\/440"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["v17030440"],"URL":"https:\/\/doi.org\/10.3390\/v17030440","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,19]]}}}