Low Tenofovir Plasma Exposure in HIV Oral Pre-exposure Prophylaxis Recipients with Gastrointestinal Disorders

Andrea Calcagno; Ivano Dal Conte; Dario Cattaneo; Roberto Testi; Massimiliano Mistrangelo; Cristina Gervasoni; Amedeo de Nicolò; Stefano Bonora; Antonio D'Avolio; Giovanni Di Perri

doi:10.1128/AAC.01902-20

Low Tenofovir Plasma Exposure in HIV Oral Pre-exposure Prophylaxis Recipients with Gastrointestinal Disorders

Antimicrob Agents Chemother. 2021 Jan 1;65(1):e01902-20. doi: 10.1128/AAC.01902-20. Epub 2020 Oct 26.

Affiliations

¹ Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy [email protected].
² Sexual Health Centre, Department of Prevention, ASL "Città di Torino", Turin, Italy.
³ Unit of Clinical Pharmacology, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy.
⁴ Department of Surgical Sciences, University of Turin, Turin, Italy.
⁵ Department of Infectious Diseases, ASST Fatebenefratelli Sacco University Hospital, Milan, Italy.
⁶ Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Turin, Italy.
⁷ Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy.

Abstract

Four pre-exposure prophylaxis (PrEP) users with gastro-intestinal disorders (sleeve gastrectomy, terminal ileitis, celiac disease or chronic diarrhea) and receiving oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) were included. Despite a self-reported high adherence, trough plasma tenofovir concentrations (after a supervised intake) were significantly lower than those observed in PrEP recipients without gastrointestinal disorders [21 (±9.1) vs. 138 (±85) ng/mL]. PrEP users with gastrointestinal disorders may need increased TDF doses or alternative prophylactic measures.