Age-related comorbidities and polypharmacy tend to be more common in older PWH, however prospective clinical trials evaluating efficacy, safety, and barrier to resistance of ARTs, with long-term follow-up, are notably lacking in this specific population.

In this 96-week follow-up, phase 3b, open-label, single arm trial, 86 virologically suppressed PWH aged ≥65 years switched from E/c/F/TAF or TDF based regimen to B/F/TAF. The median number of concomitant medications was 3 (IQR 2-5). Hypertension, CVD and diabetes were the most frequent medical co-conditions, apart from HIV (51.2%, 26.7% and 22.1%, respectively). No participants had a HIV-1 RNA≥50 c/mL at week 72 or 96. No treatment emergent resistance was observed, CD4 stayed stable and there were no study drug-related serious adverse events. Only three participants discontinued the study due to drug-related adverse events. No clinically relevant changes were observed in fasting lipids parameters and no median change (0.0kg) in weight from baseline through week 96.

Switching to B/F/TAF is shown to be an effective long-term option for virologically suppressed adults ≥65 years of age, with favorable safety and tolerability profiles through 96 weeks in this population who has a high burden of baseline comorbidities and comedications.