Repeated rectal application of a hyperosmolar lubricant is associated with microbiota shifts but does not affect PrEP drug concentrations: results from a randomized trial in men who have sex with men
| Autor: | Angela Holder, Richard E. Haaland, Clyde E. Hart, Yi-Juan Hu, Yingtian Hu, Jiahui Xu, Jeffrey Fountain, Sheila Heeke, Nicole A Pescatore, Colleen F. Kelley, LaShonda Hall, Chuong Dinh |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Drug Adult Male medicine.medical_specialty Anti-HIV Agents media_common.quotation_subject 030106 microbiology Rectum men who have sex with men HIV Infections Gut flora Emtricitabine Gastroenterology Men who have sex with men 03 medical and health sciences Pre-exposure prophylaxis Personal lubricant Internal medicine Prevotella Medicine Humans Homosexuality Male Research Articles media_common pre‐exposure prophylaxis Lubricants biology anti‐retroviral agents gut microbiota business.industry Public Health Environmental and Occupational Health HIV Middle Aged biology.organism_classification Gastrointestinal Microbiome 030104 developmental biology Infectious Diseases medicine.anatomical_structure lubricant Pre-Exposure Prophylaxis business medicine.drug Research Article |
| Zdroj: | Journal of the International AIDS Society |
| ISSN: | 1758-2652 |
| Popis: | Introduction Oral pre‐exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) is highly effective in preventing HIV infection among men who have sex with men (MSM). The effects of consistent personal lubricant use in the rectum on tissue PrEP drug concentrations and the rectal microbiota are unknown. We investigated rectal PrEP drug concentrations and the microbiota in MSM before and after repeated rectal application of a hyperosmolar lubricant. Methods We randomized 60 HIV‐negative MSM to apply 4 mL of hyperosmolar rectal lubricant daily (n = 20), take daily oral TDF/FTC (n = 19), or both (n = 21) for seven days. Blood, rectal biopsies and rectal secretions were collected via rigid sigmoidoscopy before and on day 8 after product use. Tenofovir (TFV) and FTC as well as their intracellular metabolites tenofovir‐diphosphate (TFV‐DP), FTC‐triphosphate (FTC‐TP) were measured by HPLC‐mass spectrometry. Rectal mucosal microbiota was sequenced with 16S rRNA sequencing using Illumina MiSeq. Results Seven days of lubricant application was not associated with differences in PrEP drug concentrations in rectal tissue or secretions. Lubricant use was associated with a decrease in the relative abundance of the Bacteroides genus (p = 0.01) and a non‐significant increase in the Prevotella genus (p = 0.09) in the rectum. PrEP drug concentrations in rectal tissue and secretions were not associated with microbiota composition or diversity either before or after lubricant use. Conclusions Repeated rectal application of a hyperosmolar lubricant does not affect mucosal PrEP drug concentrations but is associated with changes in the rectal microbiome. |
| Databáze: | OpenAIRE |
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