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Gan L, Xie X, Fu Y, Yang X, Ma S, Kong L, Song C, Song Y, Ren T, Long H. Safety and adherence of bictegravir/emtricitabine/tenofovir alafenamide for HIV post-exposure prophylaxis among adults in Guiyang China: a prospective cohort study. BMC Infect Dis 2024; 24:565. [PMID: 38844855 PMCID: PMC11157740 DOI: 10.1186/s12879-024-09407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/15/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The effectiveness of post-exposure prophylaxis (PEP) depends on participants adherence, making it crucial to assess and compare regimen options to enhance human immunodeficiency virus (HIV) prophylaxis strategies. However, no prospective study in China has shown that the completion rate and adherence of single-tablet regimens in HIV PEP are higher than those of multi-tablet preparations. Therefore, this study aimed to assess the completion rate and adherence of two HIV PEP regimens. METHODS In this single-center, prospective, open-label cohort study, we included 179 participants from May 2022 to March 2023 and analyzed the differences in the 28-day medication completion rate, adherence, safety, tolerance, and effectiveness of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) and tenofovir disoproxil fumarate, emtricitabine, and dolutegravir (TDF/FTC + DTG). RESULTS The PEP completion rate and adherence were higher in the BIC/FTC/TAF group than in the TDF/FTC + DTG group (completion rate: 97.8% vs. 82.6%, P = 0.009; adherence: 99.6 ± 2.82% vs. 90.2 ± 25.29%, P = 0.003). The incidence of adverse reactions in the BIC/FTC/TAF and TDF/FTC + DTG groups was 15.2% and 10.3% (P = 0.33), respectively. In the TDF/FTC + DTG group, one participant stopped PEP owing to adverse reactions (1.1%). No other participants stopped PEP due to adverse events. CONCLUSIONS BIC/FTC/TAF and TDF/FTC + DTG have good safety and tolerance as PEP regimens. BIC/FTC/TAF has a higher completion rate and increased adherence, thus, is recommended as a PEP regimen. These findings emphasize the importance of regimen choice in optimizing PEP outcomes. TRIAL REGISTRATION The study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2200059994(2022-05-14), https://www.chictr.org.cn/bin/project/edit?pid=167391 ).
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Affiliation(s)
- Lin Gan
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Xiaoxin Xie
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Yanhua Fu
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Xiaoyan Yang
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Shujing Ma
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Linghong Kong
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China
| | - Chunli Song
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Yebing Song
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Tingting Ren
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China
| | - Hai Long
- Guiyang Public Health Clinical Center, 6 Daying Road, Yunyan District, Guiyang, 550001, China.
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Januszka JE, Drwiega EN, Badowski ME. Bictegravir/Emtricitabine/Tenofovir Alafenamide for HIV-1: What is the Hidden Potential of This Emerging Treatment? HIV AIDS (Auckl) 2023; 15:705-711. [PMID: 38050483 PMCID: PMC10693755 DOI: 10.2147/hiv.s385877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/27/2023] [Indexed: 12/06/2023] Open
Abstract
Bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) is a single-tablet antiretroviral therapy regimen. B/F/TAF has become a popular treatment choice because of its small tablet size, high barrier to resistance, favorable tolerability, and limited drug-drug interaction profile. Continued research on B/F/TAF has revealed additional potential for this regimen. This review presents recent literature supporting the use of B/F/TAF as an option for consolidating therapy and maintaining virologic suppression in individuals despite M184V/I mutations. Additionally, children are a unique patient population with limited antiviral options. Standard dose B/F/TAF has demonstrated similar drug exposure in children and adolescents as adults, and low-dose B/F/TAF is approved for children living with HIV greater than two years of age and weighing at least 14 kg. Data supporting this recommendation is described in this review. Finally, despite a lack of prospective data, B/F/TAF may have a role in the future of pre- and post-exposure prophylaxis. This review discusses these discoveries and the continued exploration of the hidden potential of B/F/TAF.
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Affiliation(s)
- Jenna E Januszka
- University of Illinois at Chicago, College of Pharmacy, Chicago, IL, USA
| | - Emily N Drwiega
- University of Illinois at Chicago, College of Pharmacy, Chicago, IL, USA
| | - Melissa E Badowski
- University of Illinois at Chicago, College of Pharmacy, Chicago, IL, USA
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Liu A, Xin R, Zhang H, Dai L, Wu R(E, Wang X, Li A, Hua W, Li J, Shao Y, Gao Y, Wang Z, Ye J, bu dou re xi ti GA, Li Z, Sun L. An open-label evaluation of safety and tolerability of coformulated bictegravir/emtricitabine/tenofovir alafenamide for post-exposure prophylaxis following potential exposure to human immunodeficiency virus-1. Chin Med J (Engl) 2022; 135:2725-2729. [PMID: 36719359 PMCID: PMC9944392 DOI: 10.1097/cm9.0000000000002494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Single-tablet regimen (STR) provides a convenient once-daily regimen for the prevention of human immunodeficiency virus (HIV) infection. Here, we investigated the safety and tolerability of coformulated bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) as a three-drug, STR for post-exposure prophylaxis (PEP) in Chinese individuals. METHODS This was a prospective, open-label, single-arm trial conducted in a sexually transmitted diseases and acquired immunodeficiency syndrome clinic of a tertiary hospital in Beijing, China. Adults requiring PEP were prescribed BIC/FTC/TAF one pill once a day for 28 days. Clinical and laboratory data were collected and analyzed at baseline, weeks 2, 4, 8, 12, and 24. RESULTS Of 112 participants enrolled in the study, 109 (97.3%) were male and the mean age was 30 ± 8 years. PEP completion was 96.4% (95% confidence interval: 91.1-99.0%). Two participants stopped PEP after 2 days because the source partner was identified as HIV uninfected. One participant was excluded due to hepatitis B virus infection according to the exclusion criteria. One discontinued due to the participant's decision. No participant acquired HIV through week 24. Adherence was 98.9% (standard deviation [SD]: 3.3%) by self-reporting and 98.5% (SD: 3.5%) by pill count. Only five participants experienced mild clinical adverse events attributed to the study drug (including headache, diarrhea, and nausea) and four participants had elevated serum creatinine (grade 1). CONCLUSIONS A once daily, STR of BIC/FTC/TAF used as PEP was safe and well-tolerated with a high rate of completion and adherence in Chinese. BIC/FTC/TAF may be a good option for PEP. TRIAL REGISTRATION ChiCTR.org.cn, ChiCTR2100048080.
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Affiliation(s)
- An Liu
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Ruolei Xin
- Institute of STD/AIDS Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing 100013, China
| | - Hongwei Zhang
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Lili Dai
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | | | - Xi Wang
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Aixin Li
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Wei Hua
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Jianwei Li
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Ying Shao
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Yue Gao
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Zhangli Wang
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Jiangzhu Ye
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Gulimila A bu dou re xi ti
- Care Center, The Eighth Affiliated Hospital of Xinjiang Medical University, Urumchi, Xinjiang 830054, China
| | - Zaicun Li
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
| | - Lijun Sun
- Clinic of Center for Infection, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
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Wu Y, Zhu Q, Zhou Y, Liang S, Li R, Liang N, Li C, Lan G. Implementation of HIV non-occupational post-exposure prophylaxis for men who have sex with men in 2 cities of Southwestern China. Medicine (Baltimore) 2021; 100:e27563. [PMID: 34713829 PMCID: PMC8556056 DOI: 10.1097/md.0000000000027563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 09/02/2021] [Accepted: 10/04/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Non-occupational post-exposure prophylaxis (nPEP) has often relied on the joint work of emergency physicians and infectious disease specialists in busy emergency departments and human immunodeficiency virus (HIV)/sexually transmitted infections clinics abroad, where adherence education and follow-up are invariably reactive. In our pilot study, community-based organizations (CBOs) were invited to together implement the nPEP tailored to men who have sex with men (MSM) in 2 cities of Guangxi in Southwestern China, of which experiences and lessons drawn from would be provided to the promotion of nPEP in China.The study population enrolled MSM individuals prescribed nPEP from September 2017 to December 2019. One-to-one follow-ups by CBOs were applied through the treatment. Predictors of treatment completion were assessed by logistic regression.Of 271 individuals presented for nPEP, 266 MSM with documented treatment completion or non-completion, 93.6% completed the 28-day course of medication. Completion was associated with reporting side effects (aOR = .10; 95% CI: 0.02-0.38; P = .001). The follow-up rate of 91.9% was achieved based on the definition of loss to follow-up. No documented nPEP failures were found, although 1 MSM subsequently seroconverted to HIV due to ongoing high-risk behavior.CBOs' engagement in HIV nPEP, especially the "one-to-one" follow-up supports by peer educators partly ensure adherence and retention to nPEP. Tailored interventions are needed to address the subsequent high-risk behaviors among the MSM population.
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