Decreased Tenofovir Diphosphate Concentrations in a Transgender Female Cohort: Implications for Human Immunodeficiency Virus Preexposure Prophylaxis

Clin Infect Dis. 2019 Nov 27;69(12):2201-2204. doi: 10.1093/cid/ciz290.

Abstract

Feminizing hormone therapy (FHT) may interact with human immunodeficiency virus preexposure prophylaxis (PrEP). We found that transgender women who took FHT exhibited a 7-fold lower rectal tissue ratio of PrEP's active metabolites vs competing deoxynucleotides compared to cisgender women and men (P = .03) that inversely correlated with estradiol (ρ = -0.79; P < .05). Thus, FHT may negatively impact PrEP efficacy. Clinical Trials Registration . NCT02983110.

Keywords: HIV; feminizing hormone therapy; lower gastrointestinal tract; preexposure prophylaxis; transgender.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenine / administration & dosage
  • Adenine / analogs & derivatives*
  • Adenine / pharmacokinetics
  • Adolescent
  • Adult
  • Aged
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / pharmacokinetics*
  • Drug Monitoring
  • Female
  • HIV / drug effects*
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control
  • HIV Infections / virology
  • Humans
  • Middle Aged
  • Organophosphates / administration & dosage
  • Organophosphates / pharmacokinetics*
  • Pre-Exposure Prophylaxis*
  • Tissue Distribution
  • Transgender Persons*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-HIV Agents
  • Organophosphates
  • tenofovir diphosphate
  • Adenine

Associated data

  • ClinicalTrials.gov/NCT02983110