What are the characteristics of preexposure prophylaxis (PrEP) agents for HIV?

Updated: Oct 08, 2019
  • Author: Alejandro Delgado, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

The ideal chemoprophylactic agent should have the following characteristics:

  • A long half-life
  • Achieve high concentrations in monocytes, macrophages, and genital secretions
  • Have a high barrier for genetic resistance
  • Safe and inexpensive

The most widely studied ARV for PrEP, tenofovir DF (disoproxil fumarate), has many of these desirable characteristics. Most of the current clinical trials of PrEP involve tenofovir with or without emtricitabine. Emtricitabine/tenofovir DF (Truvada) was approved by the FDA in July 2012 for PrEP against sexual HIV acquisition by men who have sex with men (MSM), as well as for heterosexually active serodiscordant women and men.

The fixed-dose combination of emtricitabine/tenofovir AF (alafenamide) 200 mg/25 mg (Descovy) is also approved for at-risk adults and adolescents for HIV-1 pre-exposure prophylaxis (PrEP) to reduce the risk of HIV-1 infection from sex, excluding those who have receptive vaginal sex.


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