Bictegravir/emtricitabine/tenofovir alafenamide shows favorable lipid and renal changes versus other regimens in treatment-experienced HIV-1 patients

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Journal of comparative effectiveness research Published June 4, 2026 Medically reviewed June 4, 2026 Study authors: Curteis Tristan, Eddowes Lucy A, Karlsson Andrei, Luedke Hannah, Rubinstein Manon, Hempfling Mathias… PubMed ↗ DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider B/F/TAF as a safe option for long-term management in treatment-experienced people with HIV-1.

This systematic literature review and network meta-analysis evaluates bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) against other antiretroviral therapy regimens in treatment-experienced people with HIV-1. The analysis followed participants for 48 weeks and assessed lipid profiles, renal function, and safety. B/F/TAF demonstrated favorable changes in total cholesterol and triglycerides compared to comparators, while maintaining similar adverse event and discontinuation rates. The authors support B/F/TAF as a safe option for long-term management in this population.

Regarding lipid outcomes, changes in total cholesterol (TC) favored B/F/TAF with a mean difference of -12.43 and a 95% CrI of [-23.26, -1.53]. Changes in triglycerides also favored B/F/TAF, with mean differences of -15.01 (95% CrI: [-29.18, -1.06]) and -24.48 (95% CrI: [-41.60, -7.47]). In contrast, changes in HDL favored NNRTI-based regimens with a mean difference of -4.35 (95% CrI: [-7.76, -0.70]). Changes in LDL and the TC to HDL ratio were similar between groups.

Renal function showed favorable changes for B/F/TAF, with an eGFR mean difference of 3.81 (95% CrI: [1.74, 5.97]). Safety profiles were generally comparable, with adverse events and discontinuations similar to other ART regimens. The regimen was generally well tolerated. The study did not report specific serious adverse events or absolute numbers for outcomes. Funding or conflicts were not reported. The review supports B/F/TAF as a safe option for long-term management in treatment-experienced people with HIV-1.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedJun 2026

PMID42206806

View Original Abstract ↓

With modern antiretroviral therapy (ART), HIV-1 has now become a manageable chronic condition. Among treatment-experienced (TE) people with HIV-1 (PWH), ART regimens can influence metabolic and renal outcomes and adverse events such as nausea. Regimen selection increasingly prioritizes safety, tolerability and long-term acceptability. This study compared bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) with other ART regimens in TE PWH using multilevel network meta-regression (ML-NMR), focusing on lipid profile, renal function and overall safety. A systematic literature review (SLR) in June 2023 identified Phase III/IV randomized controlled trials reporting safety in adult TE PWH. ML-NMR was conducted at week 48 adjusting for age, sex, race and CD4 cell count, using individual patient data from three Phase III B/F/TAF trials (GS-US-380-1844, -1878, -4030) and aggregate data from comparator trials. At week 48, B/F/TAF demonstrated similar changes in total cholesterol (TC) to HDL ratio and LDL versus comparators. Compared with NNRTI (+ or /) F/TDF, changes in TC favored B/F/TAF (mean difference [MD; 95% CrI]: -12.43 [-23.26, -1.53]), but favored the NNRTI-based regimen for HDL (-4.35 [-7.76, -0.70]). Triglycerides changes favored B/F/TAF versus DTG/ABC/3TC (-15.01 [-29.18, -1.06]) and protease inhibitor (+ or /) b + 2 NRTIs (-24.48 [-41.60, -7.47]). eGFR changes favored B/F/TAF versus DTG/ABC/3TC (3.81 [1.74, 5.97]). With some exceptions of statistical differences in both directions, B/F/TAF generally had similar levels of adverse events and discontinuations as other ART. Switching to or remaining on B/F/TAF in TE PWH was generally well tolerated and did not worsen lipid, renal or safety outcomes versus most other contemporary ART. Improvements in select lipid parameters and stable renal function, with low rates of adverse events and discontinuation, support B/F/TAF as a safe option for long-term management in TE PWH.