Direct stringency comparison of two macaque models (single-high vs. repeat-low) for mucosal HIV transmission using an

Shambavi Subbarao1, Artur Ramos, Caryn Kim

  • 1Laboratory Branch, Division of HIV/AIDS Prevention, NCHHSTP, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

Abstract

Insights

Tenofovir disoproxil fumarate (TDF) chemoprophylaxis showed partial protection against repeated low-dose SHIV challenges. A single high-dose challenge model revealed TDF protected 40% of macaques, suggesting varying model stringency.

Area of Science:

  • Virology
  • Primate Models
  • Antiretroviral Therapy

Background:

  • Previous studies demonstrated oral tenofovir disoproxil fumarate (TDF) offered partial protection against repeated low-dose (RL) intrarectal SHIV162p3 exposure in rhesus macaques.
  • This research directly compares TDF efficacy using a single high (SH)-dose challenge strategy against prior RL challenge findings.

Purpose of the Study:

  • To compare the efficacy of oral TDF chemoprophylaxis in rhesus macaques under two different SHIV challenge models: single high-dose (SH) versus repeated low-dose (RL).
  • To evaluate the relative stringency of the SH and RL challenge models for assessing antiretroviral interventions.

Main Methods:

  • Rhesus macaques received oral TDF chemoprophylaxis.
  • Animals were challenged intrarectally with SHIV162p3 using either a single high (SH)-dose or repeated low-dose (RL) strategy.
  • Infection rates and protection efficacy of TDF were compared between the two challenge models.

Main Results:

  • Under the SH challenge, 60% of TDF-treated macaques became infected, with 40% protection observed.
  • Under the RL challenge, only 25% of TDF-treated macaques were protected.
  • Control groups showed 100% infection rates in both SH (5/5) and RL (4/4) challenge models.

Conclusions:

  • The repeated low-dose (RL) challenge model appears to be as stringent, if not more stringent, than the single high-dose (SH) model for evaluating antiretroviral interventions.
  • Findings highlight the importance of challenge model selection in assessing the efficacy of pre-exposure prophylaxis.

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