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High levels of adherence reached in two PrEP studies, but resistance cases show need for rigorous testing before prescribing
Gus Cairns, 2012-07-20 08:50:00
Two studies of pre-exposure prophylaxis (PrEP) in heterosexuals in Africa, both of which reported significant efficacy in preventing HIV infection last year, published their final results in the New England Journal of Medicine last week.
Drug level tests found that the relatively high efficacy found in the Partners PrEP trial (Baeten)and the TDF2 trial (Thigpen) were associated with high levels of adherence, with participants who did not acquire HIV infection taking about 80% of their doses, on average.
Although the studies do seem to show that high levels of adherence to PrEP are achievable, they also included some findings that underline concerns sometimes expressed about PrEP. One study found that a significant degree of bone loss was found in people taking tenofovir, and in both studies there were cases where participants had acute HIV infection when they started taking PrEP, which was only diagnosed later, and in some cases developed high levels of resistance to tenofovir and/or FTC.
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