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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Main Authors: Inès Devred, Kick Kayembe, Nadia Valin, Hayette Rougier, Bruce Wuembulua Shinga, Sidonie Lambert-Niclot, Thibault Chiarabini, Marie-Caroline Meyohas, Karine Lacombe
Format: Article
Language:English
Published: BMC 2023-09-01
Series:BMC Infectious Diseases
Subjects:
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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