Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Vigo, Spain.
Infectious Diseases Unit, Internal Medicine Department, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
Front Public Health. 2022 Oct 28;10:1005622. doi: 10.3389/fpubh.2022.1005622. eCollection 2022.
Pre-exposure prophylaxis (PrEP) has become a useful tool to reduce the transmission of human immunodeficiency virus (HIV) in key populations. In this article we assessed the effectiveness, safety, adherence, sexually transmitted infections (STIs) dynamics, and frequency of anal dysplasia among a real-life cohort of PrEP users in Northwest Spain.
A retrospective cohort study was undertaken in the Alvaro-Cunqueiro Hospital, Vigo which included every individual who started daily emtricitabine/tenofovir-disoproxil-fumarate (FTC/TDF) between November-2019 and October-2021. Clinical and epidemiological data were obtained from the patient's medical records. The effectiveness and safety of FTC/TDF were assessed by HIV serology and renal function monitoring every 3 months. Anal, urethral, and oropharyngeal exudates were collected quarterly after the baseline visit.
A total of 126 individuals were considered eligible, most of the participants had previously been diagnosed with a STI (60.3%), 22% had consumed recreational drugs in the year prior, and 13% had engaged in chemsex. At the end of the follow-up, no cases of HIV infection were detected; 3 patients had discontinued FTC/TDF because of side effects but none of them had presented renal toxicity. In addition, the diagnosis of STIs during the follow-up was common (100 cases in 54 patients). Moreover, engagement in chemsex was more common within this latter group (22 vs. 6%, = 0.013). Among the study population included in the anal screening programme, the frequency of dysplasia was 9%.
FTC/TDF was effective, safe, and tolerable in a real-life cohort; adherence remained high throughout the study period (79%). However, a high number of STIs were diagnosed, especially among patients who engaged in chemsex.
暴露前预防（PrEP）已成为减少关键人群中人类免疫缺陷病毒（HIV）传播的有用工具。本文评估了西班牙西北部真实队列中 PrEP 用户的有效性、安全性、依从性、性传播感染（STI）动态以及肛门发育不良的频率。
在维哥的阿尔瓦罗-昆凯罗医院进行了一项回顾性队列研究，该研究纳入了 2019 年 11 月至 2021 年 10 月期间开始每天服用恩曲他滨/替诺福韦二吡呋酯（FTC/TDF）的每位个体。临床和流行病学数据从患者的病历中获得。通过 HIV 血清学和肾功能监测每 3 个月评估 FTC/TDF 的有效性和安全性。基线就诊后每季度采集肛门、尿道和口咽分泌物。
共有 126 名符合条件的个体被认为合格，大多数参与者此前被诊断患有性传播感染（60.3%），22%的参与者在过去一年中曾使用过娱乐性药物，13%的参与者曾参与过性滥交。在随访结束时，未发现 HIV 感染病例；3 名患者因副作用停止使用 FTC/TDF，但均未出现肾毒性。此外，在随访期间诊断出性传播感染很常见（54 名患者中有 100 例）。此外，在后者组中，性滥交更为常见（22 例比 6%， = 0.013）。在包括在肛门筛查计划中的研究人群中，发育不良的频率为 9%。
FTC/TDF 在真实队列中有效、安全且可耐受；整个研究期间的依从性仍然很高（79%）。然而，诊断出大量性传播感染，尤其是在参与性滥交的患者中。
