Evaluation of the treatment efficacy and side effect profiles of different treatment regimens in naïve HIV patients

Antiretroviral therapy (ART) regimens in HIV treatment are continuously evolving, offering more effective and better-tolerated options in clinical practice. In our study, medical records of 161 patients followed with HIV/AIDS between 2020 and 2024 were retrospectively evaluated. Based on real-world data, the virological, im-munological, renal, metabolic and adverse event profiles of Bictegravir/Tenofovir Alafenamide/Emtricitabine (BIC/TAF/FTC) and Dolutegravir/Tenofovir Disoproxil Fumarate/Emtricitabine (DTG/TDF/FTC) regimens were compared. Both regimens were found to have high virological efficacy, and neither demonstrated superiority over the other. However, the BIC/TAF/FTC regimen provided a better virological response in patients with CD4 <200 cells/mm³, whereas the DTG/TDF/FTC regimen showed lower efficacy in this patient group. Additionally, the long-term immunolo-gical efficacy of the BIC/TAF/FTC regimen was found to be superior. Regarding renal function, a decrease in eGFR was detected in both regimens, with similar rates of clinically significant nephrotoxicity. In terms of metabolic effects, the BIC/TAF/FTC regimen was associated with a notable increase in body weight and lipid levels, whereas the DTG/TDF/FTC regimen remained more neutral regarding lipid profile. In the assessment of cardiovascular risk, a significant increase in the Framingham risk score was observed in the BIC/TAF/FTC group, whereas no notab-le change was seen in the DTG/TDF/FTC group. The rates of drug discontinuation due to adverse events and all causes were found to be higher in the DTG/TDF/FTC group. The BIC/TAF/FTC regimen stands out for maintaining a strong virological response even in individuals with low CD4 counts; however, its long-term use sho-uld take into account metabolic effects such as weight gain, dyslipidemia, and inc-reased cardiovascular risk. DTG/TDF/FTC, whereas it may be considered a more metabolically favorable option for individuals at risk of weight gain and dyslipide-mia.