To explore the effects of tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) on blood lipid.

The relevant databases (up to August 31, 2021) were searched. The data of dyslipidemia in treatment of hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection with TAF (trial group) and TDF (control group) in randomized controlled trials (RCTs) were collected. Methodological quality was evaluated by bias risk assessment tool of Cochrane collaborative network, and the meta-analysis was conducted using RevMan 5.3 software. The effect value was the risk ratio (RR) and its 95% confidence interval (CI).

A total of 11 RCTs were enrolled in the analysis, including 4 on the treatment of hepatitis B (HBV subgroup) and 7 on the treatment of AIDS (HIV subgroup), and the methodological quality evaluation results showed low risk of bias for all. Eleven thousand eight hundred and eighty-eight patients were involved in the 11 RCTs, of which 6 273 were in the trial group and 5 615 in the control group. The results of meta-analysis showed that the incidences of increased low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) with the severity of ≥3 grade were higher in the trial group than those in the control group and the differences of incidences in LDL-C and TC increase were significant between the 2 groups [LDL-C: 2.9% (157/5 347) vs. 0.8% (37/4 727), RR=3.39, 95%CI: 2.35-4.89, P=0.001; TC: 0.7% (36/4 880) vs. 0.1% (6/4 397), RR=4.25, 95%CI: 1.91-9.45, P<0.001; TG: 0.5% (16/3 157) vs. 0.3% (8/3 102) , RR=1.83, 95%CI: 0.81-4.15, P=0.140]. The changes of blood lipid after treatment were compared and the results showed that the increase of LDL-C was higher in the trial group (14.00 mg/dl) than that in the control group (4.00 mg/dl), and the difference was statistically significant (P=0.004).

TAF can significantly increase the levels of LDL-C and TC in patients.

Tenofovir; Dyslipidemias; Hepatitis B; HIV infections