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TDF to TAF Switch — SCE Infectious Diseases MCQ

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ModerateHIV MedicineTDF to TAF SwitchSCE Infectious Diseases

A 30-year-old man with HIV (CD4 520, VL <50 on ART) reports difficulty with Tenofovir DF/Emtricitabine tablets due to their size. His clinician suggests switching to Tenofovir AF. What important counselling point applies?

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Correct answer: D — TAF is associated with higher lipid levels compared to TDF

While TAF has significant advantages over TDF (less renal and bone toxicity), switching from TDF to TAF is associated with increases in total cholesterol, LDL cholesterol, and triglycerides. This is because TDF has a lipid-lowering effect that is lost when switching to TAF. In patients with pre-existing cardiovascular risk factors, this lipid increase may be clinically significant and should be monitored. Fasting lipids should be checked 3–6 months post-switch with appropriate lipid management if needed.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections