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Estimated pill intake with on-demand PrEP with oral TDF/FTC using TFV-DP concentration in dried blood spots in the ANRS IPERGAY trial

2021; Oxford University Press; Volume: 76; Issue: 10 Linguagem: Inglês

10.1093/jac/dkab253

1460-2091

Lauriane Goldwirt, Rebecca Bauer, Geoffroy Liégeon, Isabelle Charreau, Constance Delaugerre, Laurent Cotte, Gilles Pialou, Éric Cua, Aïcha Laghzal, Lane Buschman, Peter L. Anderson, Samia Mourah, Laurence Meyer, Jean‐Michel Molina,

LGBTQ Health, Identity, and Policy

Abstract Background Tenofovir diphosphate (TFV-DP) concentration in dried blood spots (DBSs) is a reliable pharmacokinetics biomarker of adherence to tenofovir disoproxil fumarate (TDF). We aimed to use DBSs to estimate pill intake among participants using on-demand pre-exposure prophylaxis (PrEP) and to identify predictive factors associated with higher TFV-DP concentrations. Methods DBSs were collected at the last study visit of the open-label phase of the ANRS IPERGAY study, assessing on-demand oral TDF/emtricitabine for PrEP among MSM and transgender female participants. We quantified TFV-DP in DBSs centrally. We assessed correlation between pill count and TFV-DP concentration by Spearman correlation and explored associations between participant demographics, sexual behaviour and PrEP use during sexual intercourse (SI) with TFV-DP concentrations by univariate and multivariate logistic regression models. Results The median age of the 245 participants included in this study was 40 years, with a median body weight of 73 kg. Median (IQR) TFV-DP concentration reached 517 (128–868) fmol/punch, corresponding to an estimated intake of 8–12 tablets per month (2–3 doses per week). Only 39% of participants had a TFV-DP concentration above 700 fmol/punch. TFV-DP concentrations were moderately correlated with pill count (r: 0.59; P < 0.001). In multivariate analysis, only systematic use of PrEP during SI and more frequent episodes of SI in the past 4 weeks were significantly associated with higher TFV-DP levels [OR (95% CI): 11.30 (3.62–35.33) and 1.46 (1.19–1.79), respectively; P < 0.001]. Conclusions Among participants using on-demand PrEP, estimated pill intake reached 8–12 tablets per month and was correlated with frequency and systematic use of PrEP for SI.