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Daily tenofovir disoproxil fumarate (TDF)/emtricitabine as pre-exposure prophylaxis (PrEP) significantly reduces HIV acquisition. This safe and effective HIV prevention strategy has high efficacy when adherence is optimal.

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Pharmacology

Background:

  • An estimated 40,000 Americans and 2 million globally contract HIV annually.
  • Combination antiretroviral therapy, tenofovir disoproxil fumarate (TDF)/emtricitabine, is an effective HIV prevention method.
  • Current uptake of TDF/emtricitabine for pre-exposure prophylaxis (PrEP) in the US is below 20% among eligible individuals.

Purpose of the Study:

  • To review the efficacy and safety of TDF/emtricitabine for HIV pre-exposure prophylaxis (PrEP).
  • To highlight the potential of PrEP to reduce new HIV infections.

Main Methods:

  • A PubMed search was conducted for English-language articles published between 2010 and 2018.
  • Search terms included "pre-exposure," "prophylaxis," "HIV," and "PrEP."
  • Included four placebo-controlled randomized clinical trials evaluating daily TDF/emtricitabine.

Main Results:

  • Daily TDF/emtricitabine for PrEP demonstrated significant HIV acquisition reduction in key populations.
  • Efficacy exceeds 90%, strongly linked to adherence.
  • The regimen is safe and well-tolerated, with only 2% discontinuing due to adverse effects.
  • HIV resistance to TDF/emtricitabine during PrEP is rare (<0.1%).

Conclusions:

  • TDF/emtricitabine is a safe and effective therapy for preventing HIV transmission.
  • Increased prescription of TDF/emtricitabine for at-risk individuals can decrease new HIV infections.
  • Strategies to identify high-risk individuals and improve adherence are crucial for maximizing PrEP's impact.