BACKGROUND: TAF was originally approved in Europe for CLWHIV aged =6 years in 2016, initially as part of fixed-dose combinations (some approvals were extended to age =2 years in 2022). Data are limited on TAF uptake and outcomes in this population.
METHODS: CLWHIV aged<18 years at HIV diagnosis and followed in 11 cohorts across Europe were included. Uptake of TAF, characteristics at TAF start and viral suppression (VS) (viral load (VL)<50c/ml) at 6, 12 and 18-months on TAF were described by treatment and VL status at TAF start.
RESULTS: Of 3318 in follow-up since 2016, 670 (20%) ever received TAF; 56% were female; 95% perinatally acquired HIV or were aged<10 years at entry to HIV care; 36% from the UK, 26% Spain, 24% Italy, 15% elsewhere in Europe; median age at ART initiation was 3.5[IQR 0.6,8.8] years.
At TAF start 11% were aged 5-11, 24% 12-17, 27% 18-23 and 20% =24 years. Half (48%) were on an INSTI-based regimen, 31% PI, 13% NNRTI, 7% other/multiple classes; 66% previously used TDF. Twenty-one (3%) were treatment naïve and 649 (97%) treatment-experienced, of whom 51% had VL<50, 24% were viremic (VL=50) and 25% had unknown VL at TAF start. Those treatment-experienced and viremic, and those naïve, had the lowest CD4 counts (Table). Median duration on TAF was 1.2[0.6,2.0] years. At 6, 12 and 18-months on TAF, overall VS was >80% but was lower in those treatment-experienced and viremic at TAF start.

Table: Characteristics at start of TAF by treatment status and viral load
(Median [IQR])
Naïve, n=21
Treatment experienced, VL<50, n=330
Treatment experienced, VL=50, n=157
Treatment experienced, VL unknown, n=162
Age (years)
CD4 count (n=19,273,147,47)
Log viral load(n=18,157)


CONCLUSIONS: CLWHIV who were virally suppressed at TAF start maintained good levels of suppression over follow-up, and two-thirds of those who were treatment-experienced and viremic at TAF start achieved viral suppression. Longer-term follow-up data are needed, particularly in younger children.

Download the e-Poster (PDF)