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Observational Study
. 2023 Sep 4;23(1):578.
doi: 10.1186/s12879-023-08544-x.

Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV

Inès Devred  1 , Kick Kayembe  2 , Nadia Valin  3 , Hayette Rougier  3   4 , Bruce Wuembulua Shinga  3 , Sidonie Lambert-Niclot  5   6 , Thibault Chiarabini  3 , Marie-Caroline Meyohas  3   5 , Karine Lacombe  3   5   7
Affiliations
Observational Study

Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV

Inès Devred et al. BMC Infect Dis. .

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.

Keywords: Adherence; Completion rate; Doravirine; HIV; Post-exposure prophylaxis.

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Conflict of interest statement

KL declared that she received honoraria (advisory boards and educational activities) and travel grants from MSD, Gilead, ViiV Healthcare, and Janssen. SLN declared that she received honoraria (educational activities) and travel grants from MSD, Gilead and ViiV Healthcare. The other authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Flow chart of participants who consulted after sexual exposure to HIV and were prescribed EVG/c/FTC/TAF in 2020 or DOR/3TC/TDF in 2021
See this image and copyright information in PMC

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