Maple Leaf Medical Clinic, Toronto, ON, Canada.
Women's College Research Institute, Toronto, ON, Canada.
Antivir Ther. 2023 Jun;28(3):13596535231182505. doi: 10.1177/13596535231182505.
Potential bidirectional drug-drug interactions between feminizing hormone therapy (FHT) and antiretroviral therapy (ART) are of concern for trans women with HIV and their healthcare providers. This study aimed to characterize patterns of FHT and ART among trans women with HIV and to compare serum hormone levels to trans women without HIV.
Charts of trans women were reviewed at seven HIV primary care or endocrinology clinics in Toronto and Montreal from 2018 to 2019. ART regimens, FHT use, serum estradiol, and serum testosterone levels were compared on the basis of HIV status (positive, negative, missing/unknown).
Of 1495 trans women, there were 86 trans women with HIV, of whom 79 (91.8%) were on ART. ART regimens were most commonly integrase inhibitor-based (67.4%), many boosted with ritonavir or cobicistat (45.3%). Fewer (71.8%) trans women with HIV were prescribed FHT, compared to those without HIV (88.4%) and those with missing/unknown status (90.2%, 0.001). Among trans women on FHT with recorded serum estradiol ( = 1153), there was no statistical difference in serum estradiol between those with HIV (median: 203 pmol/L, IQR: 95.5, 417.5) and those with negative (200 mol/L [113, 407]) or missing/unknown HIV status (227 pmol/L [127.5, 384.5) ( 0.633). Serum testosterone concentrations were also similar between groups.
In this cohort, trans women with HIV were prescribed FHT less often than trans women with negative or unknown HIV status. There was no difference in serum estradiol or testosterone levels of trans women on FHT regardless of HIV status, providing reassurance regarding potential drug-drug interactions between FHT and ART.
激素替代疗法（FHT）与抗逆转录病毒疗法（ART）之间可能存在药物相互作用，这令感染 HIV 的跨性别女性及其医疗保健提供者感到担忧。本研究旨在描述感染 HIV 的跨性别女性中 FHT 和 ART 的应用模式，并比较感染 HIV 与未感染 HIV 的跨性别女性的血清激素水平。
回顾 2018 年至 2019 年期间，多伦多和蒙特利尔的七家 HIV 初级保健或内分泌诊所中感染 HIV 的跨性别女性的病历。根据 HIV 状态（阳性、阴性、缺失/未知）比较 ART 方案、FHT 使用、雌二醇和睾酮的血清水平。
在 1495 名跨性别女性中，有 86 名感染 HIV，其中 79 名（91.8%）正在接受 ART 治疗。ART 方案最常基于整合酶抑制剂（67.4%），其中许多方案联合使用利托那韦或考比司他（45.3%）。与未感染 HIV（88.4%）和 HIV 状态缺失/未知（90.2%）的跨性别女性相比，感染 HIV 的跨性别女性使用 FHT 的比例更低（71.8%， 0.001）。在接受 FHT 治疗且记录了血清雌二醇的跨性别女性中（=1153），感染 HIV 与 HIV 阴性（中位数：203 pmol/L，IQR：95.5，417.5）和 HIV 状态缺失/未知（227 pmol/L，[127.5，407.5]）的跨性别女性之间的血清雌二醇水平没有统计学差异（ 0.633）。各组间的血清睾酮浓度也相似。
在本队列中，与 HIV 阴性或 HIV 状态未知的跨性别女性相比，感染 HIV 的跨性别女性使用 FHT 的频率更低。接受 FHT 治疗的跨性别女性无论 HIV 状态如何，其血清雌二醇或睾酮水平无差异，这为 FHT 和 ART 之间可能发生的药物相互作用提供了保证。
