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. 2023 Nov 6;78(11):2653-2659.
doi: 10.1093/jac/dkad270.

Oestradiol concentrations in trans women with HIV suppressed on unboosted integrase inhibitor regimens versus trans women without HIV taking oral oestradiol: a pilot study

Mona Loutfy  1   2   3 , Ashley Lacombe-Duncan  1   4 , Alice Tseng  5   6 , Yasmeen Persad  1 , Angela Underhill  1 , V Logan Kennedy  1 , Ian Armstrong  7 , Raymond Fung  8 , Amy Bourns  3   9 , Quang Nguyen  3   9 , Sue Hranilovic  10 , Thea Weisdorf  10 , L Y L Chan  3   11 , Hannah Kia  12 , Roberta Halpenny  2 , Harshita Iyer  1 , Nirubini Jeyarajah  2 , George Kovchazov  2 , Jennifer McCully  2 , Kimberly K Scarsi  13
Affiliations

Oestradiol concentrations in trans women with HIV suppressed on unboosted integrase inhibitor regimens versus trans women without HIV taking oral oestradiol: a pilot study

Mona Loutfy et al. J Antimicrob Chemother. .

Abstract

Background: Feminizing hormone therapy (FHT) is essential to many trans women. Concern about negative drug interactions between FHT and ART can be an ART adherence barrier among trans women with HIV.

Objectives: In this single-centre, parallel group, cross-sectional pilot study, we measured serum oestradiol concentrations in trans women with HIV taking FHT and unboosted integrase strand transfer inhibitor (INSTI)-based ART versus trans women without HIV taking FHT.

Methods: We included trans women with and without HIV, aged ≥18 years, taking ≥2 mg/day of oral oestradiol for at least 3 months plus an anti-androgen. Trans women with HIV were on suppressive ART ≥3 months. Serum oestradiol concentrations were measured prior to medication dosing and 2, 4, 6 and 8 h post-dose. Median oestradiol concentrations were compared between groups using Wilcoxon rank-sum tests.

Results: Participants (n = 8 with HIV, n = 7 without) had a median age of 32 (IQR: 28, 39) years. Among participants, the median oral oestradiol dose was 4 mg (range 2-6 mg). Participants had been taking FHT for a median of 4 years (IQR: 2, 8). Six trans women with HIV were taking bictegravir/emtricitabine/tenofovir alafenamide and two were taking dolutegravir/abacavir/lamivudine. All oestradiol concentrations were not significantly different between groups. Eleven (73%) participants had target oestradiol concentrations in the range 200-735 pmol/L at C4h (75% among women with HIV, 71% among those without HIV).

Conclusions: Oestradiol concentrations were not statistically different in trans women with HIV compared with those without HIV, suggesting a low probability of clinically relevant drug-drug interactions between FHT and unboosted INSTI-based ART.

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Figures

Figure 1.
Figure 1.
Median (IQR) oestradiol concentration–time for trans women with HIV (n = 8), and trans women without HIV (n = 7). This figure appears in colour in the online version of JAC and in black and white in the print version of JAC.
See this image and copyright information in PMC

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