Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV
Abstract HIV post- exposure prophylaxis (PEP) is a prevention tool for individuals with a recent potential exposure to HIV. Doravirine has been available since 2019 in combination with tenofovir disoproxil fumarate and lamivudine and has not been evaluated as a PEP. DOR/3TC/TDF is our department’s m...
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BMC
2023-09-01
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Online Access: | https://doi.org/10.1186/s12879-023-08544-x |
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author | Inès Devred Kick Kayembe Nadia Valin Hayette Rougier Bruce Wuembulua Shinga Sidonie Lambert-Niclot Thibault Chiarabini Marie-Caroline Meyohas Karine Lacombe |
author_facet | Inès Devred Kick Kayembe Nadia Valin Hayette Rougier Bruce Wuembulua Shinga Sidonie Lambert-Niclot Thibault Chiarabini Marie-Caroline Meyohas Karine Lacombe |
author_sort | Inès Devred |
collection | DOAJ |
description | Abstract HIV post- exposure prophylaxis (PEP) is a prevention tool for individuals with a recent potential exposure to HIV. Doravirine has been available since 2019 in combination with tenofovir disoproxil fumarate and lamivudine and has not been evaluated as a PEP. DOR/3TC/TDF is our department’s most commonly prescribed PEP treatment since 2021. This study evaluates the completion rate of the DOR/3TC/TDF as compared to EVG/c/FTC/TAF for PEP, which was the regimen prescribed until 2020 in our hospital. This retrospective observational study was conducted between January 2020 and September 2021. The subjects included consecutively were adults who consulted for an HIV sexual exposure accident and for whom DOR/3TC/TDF in 2021 or EVG/c/FTC/TAF in 2020 was prescribed. The outcomes were the completion rate to the end of treatment (28 days), the seroconversion rate, and the description of side effects. During the study period, 311 people were included: 140 treated with DOR/3TC/TDF and 171 treated with EVGc/FTC/TAF. Considering subjects with a follow-up visit, the completion rate was 96.8% (90/93) in the DOR/3TC/TDF group, and 94.6% (123/130) in the EVG/c/FTC/TAF group (p-value: 0.53). The number of people lost to follow-up was nearly equivalent in both groups: 27.1% (38/140) in the DOR/3TC/TDF group and 23.4% (40/171) in the EVG/c/FTC/TAF group (p-value: 0.45). A side effect was described for 38% (36/94) in the DOR/3TC/TDF group, and 29.7% (38/128) in the EVG/c/FTC/TAF group. No cases of seroconversion were observed. DOR/3TC/TDF appears to have a similar safety profile to EVG/c/FTC/TAF. Due to its lower cost, it seems to be a treatment option for consideration in the context of HIV-exposure accidents. |
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spelling | doaj.art-2d5057ebf4eb4e4a9ff804e4acb3c1662023-11-19T12:30:10ZengBMCBMC Infectious Diseases1471-23342023-09-012311710.1186/s12879-023-08544-xProphylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIVInès Devred0Kick Kayembe1Nadia Valin2Hayette Rougier3Bruce Wuembulua Shinga4Sidonie Lambert-Niclot5Thibault Chiarabini6Marie-Caroline Meyohas7Karine Lacombe8Hôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesSorbonne UniversitéHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesHôpital Saint-Antoine, Assistance Publique Des Hôpitaux de Paris, Service Des Maladies Infectieuses Et TropicalesAbstract HIV post- exposure prophylaxis (PEP) is a prevention tool for individuals with a recent potential exposure to HIV. Doravirine has been available since 2019 in combination with tenofovir disoproxil fumarate and lamivudine and has not been evaluated as a PEP. DOR/3TC/TDF is our department’s most commonly prescribed PEP treatment since 2021. This study evaluates the completion rate of the DOR/3TC/TDF as compared to EVG/c/FTC/TAF for PEP, which was the regimen prescribed until 2020 in our hospital. This retrospective observational study was conducted between January 2020 and September 2021. The subjects included consecutively were adults who consulted for an HIV sexual exposure accident and for whom DOR/3TC/TDF in 2021 or EVG/c/FTC/TAF in 2020 was prescribed. The outcomes were the completion rate to the end of treatment (28 days), the seroconversion rate, and the description of side effects. During the study period, 311 people were included: 140 treated with DOR/3TC/TDF and 171 treated with EVGc/FTC/TAF. Considering subjects with a follow-up visit, the completion rate was 96.8% (90/93) in the DOR/3TC/TDF group, and 94.6% (123/130) in the EVG/c/FTC/TAF group (p-value: 0.53). The number of people lost to follow-up was nearly equivalent in both groups: 27.1% (38/140) in the DOR/3TC/TDF group and 23.4% (40/171) in the EVG/c/FTC/TAF group (p-value: 0.45). A side effect was described for 38% (36/94) in the DOR/3TC/TDF group, and 29.7% (38/128) in the EVG/c/FTC/TAF group. No cases of seroconversion were observed. DOR/3TC/TDF appears to have a similar safety profile to EVG/c/FTC/TAF. Due to its lower cost, it seems to be a treatment option for consideration in the context of HIV-exposure accidents.https://doi.org/10.1186/s12879-023-08544-xPost-exposure prophylaxisDoravirineHIVAdherenceCompletion rate |
spellingShingle | Inès Devred Kick Kayembe Nadia Valin Hayette Rougier Bruce Wuembulua Shinga Sidonie Lambert-Niclot Thibault Chiarabini Marie-Caroline Meyohas Karine Lacombe Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV BMC Infectious Diseases Post-exposure prophylaxis Doravirine HIV Adherence Completion rate |
title | Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV |
title_full | Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV |
title_fullStr | Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV |
title_full_unstemmed | Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV |
title_short | Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV |
title_sort | prophylaxis by doravirine lamivudine tenofovir disoproxil fumarate or elvitegravir cobicistat emtricitabine tenofovir alafenamide after sexual exposure to hiv |
topic | Post-exposure prophylaxis Doravirine HIV Adherence Completion rate |
url | https://doi.org/10.1186/s12879-023-08544-x |
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