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01-12-2020 | Tenofovir | Current Opinion

Lamivudine/Tenofovir Disoproxil Fumarate is an Appropriate PrEP Regimen

Authors: Andrew Mujugira, Jared M. Baeten, Ioannis Hodges-Mameletzis, Jessica E. Haberer

Published in: Drugs | Issue 18/2020

Abstract

Oral pre-exposure prophylaxis (PrEP) containing tenofovir disoproxil fumarate (TDF) co-formulated with emtricitabine (FTC) or lamivudine (3TC) is recommended as an additional prevention option for persons at substantial risk of HIV infection by both the World Health Organization (WHO) and the US President’s Emergency Plan for AIDS Relief (PEPFAR). The WHO and PEPFAR consider 3TC clinically interchangeable with FTC for PrEP given comparable pharmacologic equivalence, resistance and toxicity patterns, and indirect clinical trial evidence from TDF-containing studies. Globally, FTC/TDF has been widely used in clinical trials, open-label extension studies and demonstration projects. Thus, most PrEP efficacy and safety data are based on FTC/TDF use in heterosexual women and men, men who have sex with men, and people who inject drugs. However, generic 3TC/TDF is less expensive than FTC/TDF, is already available in supply chains for HIV drugs, and has 60–70% of the global adult market share, making it particularly appealing in settings with limited availability or affordability of FTC/TDF. Compelling indirect evidence suggests that scaling up use of 3TC/TDF is potentially cost saving for HIV programs in settings where restricting drug choice to FTC/TDF would delay PrEP implementation. Guideline committees and public health decision-makers in countries should encourage flexibility in PrEP drug selection, support off-label use of 3TC/TDF, and approve use of generic formulations to decrease the cost of PrEP medications and accelerate PrEP delivery through the public and private sectors.

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Title: Lamivudine/Tenofovir Disoproxil Fumarate is an Appropriate PrEP Regimen
Authors: Andrew Mujugira
Jared M. Baeten
Ioannis Hodges-Mameletzis
Jessica E. Haberer
Publication date: 01-12-2020
Publisher: Springer International Publishing
Keywords: Tenofovir
Lamivudine
Human Immunodeficiency Virus
Lamivudine
Published in: Drugs / Issue 18/2020
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI: https://doi.org/10.1007/s40265-020-01419-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Lamivudine/Tenofovir Disoproxil Fumarate is an Appropriate PrEP Regimen

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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