Tenofovir DF/emtricitabine/rilpivirine as HIV post-exposure prophylaxis: results from a multicentre prospective study
| Autor: | Nolwenn Hall, Clotilde Allavena, Hikombo Hitoto, Solène Secher, Christophe Michau, Bénédicte Bonnet, Marie Chauveau, Sabelline Bouchez, Dominique Merrien, Lucia Perez, Eric Billaud, François Raffi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Anti-HIV Agents medicine.medical_treatment 030106 microbiology HIV Infections Emtricitabine Medication Adherence 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Antiretroviral Therapy Highly Active Internal medicine medicine Humans Pharmacology (medical) Prospective Studies 030212 general & internal medicine Lost to follow-up Post-exposure prophylaxis Tenofovir Adverse effect Aged Pharmacology business.industry Rilpivirine Drug holiday Middle Aged Viral Load Regimen Treatment Outcome Infectious Diseases chemistry Tolerability HIV-1 Female Post-Exposure Prophylaxis business medicine.drug |
| Zdroj: | Journal of Antimicrobial Chemotherapy. 74:1021-1027 |
| ISSN: | 1460-2091 0305-7453 |
| DOI: | 10.1093/jac/dky547 |
| Popis: | Objectives Since 2016, French guidelines have recommended the single-tablet regimen of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/rilpivirine (RPV) as HIV post-exposure prophylaxis (PEP), but few data support this usage. We evaluated the tolerability, treatment completion and occurrence of HIV seroconversion associated with this combination in occupational and non-occupational PEP. Patients and methods We conducted an observational, prospective, multicentre, open-label, non-randomized study in five French HIV centres. Adults requiring PEP according to national French guidelines were prescribed TDF/FTC/RPV one pill once a day for 28 days. Clinical and biological tolerability was assessed at week 4; occurrence of HIV seroconversion was evaluated after week 16. Results From March 2016 to March 2017, 163 courses of PEP were prescribed for 150 sexual exposures (44% heterosexual and 56% MSM) and 13 non-sexual exposures. Five participants stopped PEP after a few days because the source person was HIV uninfected. Of the remaining 158 individuals, 15 (9.5%) were lost to follow-up at week 4, 7 (4.4%) prematurely discontinued PEP [patient's decision/non-adherence (n = 3) or adverse events (gastrointestinal intolerance n = 3, fatigue n = 1)] and 136 (86.1%) completed the 28 day treatment. Overall, 69.6% of participants declared at least one adverse event, mostly of mild to moderate intensity and no serious adverse events or hepatic or renal toxicity occurred. No HIV seroconversion occurred at week 16. Conclusions The low rate of premature treatment interruption, the good tolerability and the absence of documented HIV seroconversion support the current French guidelines of a 28 day course of TDF/FTC/RPV for sexual and non-sexual PEP. |
| Databáze: | OpenAIRE |
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