HIV Post-Exposure Prophylaxis (PEP) and the Efficacy of Biktarvy
HIV post-exposure prophylaxis (PEP) is a crucial HIV prevention strategy. Studies on simian immunodeficiency virus (SIV), which is closely related to HIV, have shown that a combination of antiviral drugs can reduce infection risk if administered within 72 hours of exposure. Current guidelines recommend initiating PEP as soon as possible after potential HIV exposure, with a maximum window of 72 hours.
Research on Biktarvy for PEP
Researchers at Fenway Health in Boston, a clinic and research center serving the LGBT community, conducted a study on the use of Biktarvy as PEP. Biktarvy is a single-pill regimen containing:
- Bictegravir (50 mg)
- TAF (tenofovir alafenamide) (25 mg)
- FTC (emtricitabine) (200 mg)
Biktarvy is widely used in high-income countries for HIV treatment due to its efficacy and tolerability.
Study Methodology and Findings
The study involved 52 adults who had recent potential exposure to HIV and sought PEP. Participants underwent brief interviews and HIV rapid testing. Those who tested negative for HIV were provided with a 28-day supply of Biktarvy. Follow-up testing up to two months later confirmed that all participants remained HIV negative, and the medication was well-tolerated with mild and uncommon side effects.
Recruitment and Participant Profile
Participants, who may have been exposed to HIV through unprotected sex, were referred through:
- Primary care providers
- An HIV treatment and prevention clinic hotline
- Self-referrals after community education campaigns
The study’s participants were predominantly men (49 out of 52), mostly gay or bisexual, with an average age of 37 years (ranging from 21 to 71). The ethnic distribution was 77% White, 12% multiracial, and 12% Hispanic. Notably, 56% reported more than one recent potential HIV exposure.
Side Effects and Completion Rates
Common side effects included:
- Nausea or vomiting (15%)
- Fatigue (10%)
- Diarrhea or loose stools (8%)
Most symptoms were mild and temporary. However, one participant discontinued due to excessive fatigue. Overall, 90% of participants completed the 28-day PEP regimen, while 10% lost contact with the clinic.
Comparative Analysis and Recommendations
Researchers compared their findings with historical PEP regimens, concluding that Biktarvy was better tolerated. They also noted that other PEP regimens, such as those involving dolutegravir, TDF, and FTC, require multiple pills daily.
Conclusion: Biktarvy PEP
The results are promising, suggesting that Biktarvy is an effective and well-tolerated PEP option. Larger studies with diverse populations are needed to confirm these findings. For individuals with ongoing HIV exposure risks, discussing HIV pre-exposure prophylaxis (PrEP) with a healthcare provider is recommended.