For HIV PrEP, FTC-TDF as safe as aspirin




The combination oral therapeutic emtricitabine-tenofovir disoproxil fumarate (FTC-TDF) for pre-exposure prophylaxis (PrEP) for HIV infection compares favorably to aspirin in terms of user safety, according to a review by researchers at the David Geffen School of Medicine, University of California Los Angeles.

For the review, Dr. Noah Kojima and Dr. Jeffrey Klausner assessed five major studies on PrEP for HIV infection. The numbers needed to harm (NNH) were calculated for FTC-TDF for HIV infection PrEP and aspirin usage. For FTC-TDF PrEP, the NNH in homosexual men and transexual women was 1 case per 114 person-years for nausea and 96 person-years for unintentional weight loss. In heterosexual couples, the NNH was 68 person-years for moderate decreased neutrophil count.

For aspirin, the NNH for any bleeding problem was 15 person-years, 123 person-years for any gastrointestinal bleeding, and 909 for major gastrointestinal bleeding in men. In women, the NNH for easy bruising was 10 person-years.

While researchers acknowledged that long-term studies are needed, it appears FTC-TDF for PrEP for HIV infection favorably compares to aspirin in terms of user safety.

“Given the observed safety and efficacy of FTC-TDF for PrEP for HIV infection and intent of the majority of high-risk MSM to use PrEP, physicians should now actively look for patients who may benefit from it. A ‘duty to prevent’ suggests that physicians should identify patients in their practice with behaviors that might put them at risk for HIV infection and offer PrEP routinely,” the investigators concluded.

Find the full study in Open Forum Infectious Diseases (doi: 10.1093/ofid/ofv221).

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