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 Nov 20;135(22):2725-2729. doi: 10.1097/CM9.0000000000002494.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use
  • Drug Combinations
  • Emtricitabine / therapeutic use
  • Female
  • HIV Infections* / prevention & control
  • HIV-1*
  • Heterocyclic Compounds, 4 or More Rings / therapeutic use
  • Humans
  • Male
  • Post-Exposure Prophylaxis*
  • Prospective Studies
  • Tablets / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-HIV Agents
  • bictegravir
  • Emtricitabine
  • Heterocyclic Compounds, 4 or More Rings
  • Tablets
  • tenofovir alafenamide
  • Drug Combinations