P17.01
Background: Post-exposure prophylaxis (PEP) to prevent HIV transmission after high risk exposures has been recommended for more than a decade, but older regimens using 3 medications have been inconvenient and/or had many side effects. Quad contains one integrase, and 2 reverse transcriptase, inhibitors, and could be used as a single pill, taken once a day for PEP.
Methods: Since 1997, a Boston community health center has provided NPEP. Between 5/13 and 3/14, 48 patients (pts) who presented for PEP agreed to initiate a Quad regimen. Analyses include descriptive findings, chi-square and Fisher exact tests to compare symptoms and completion rates with Quad NPEP compared to prior PEP regimens used at this site.
Results: Of 48 enrolled pts, 47 were MSM and one was a woman. Most (72.9%) were White, 10.4% Black; their ages ranged from 20 to 62 y.o. The study retention rate was 95%. One pt was switched to another regimen when his baseline creatinine was elevated. Another pt discontinued Quad after reporting acute side effects, but later disclosed concomitant use of TDF/FTC/Efavirenz. One pt discontinued Quad because of diarrhea, which was noted by 44%, but usually (88%) was mild, and often self-limited. Other common adverse events were: nausea/vomiting (31%), fatigue (25%), flatulence (25%), abdominal discomfort (15%), and abnormal dreams (13%). These symptoms were usually mild, and there were no severe adverse events reported. In comparison, prior Fenway PEP pts who used 3 drug regimens containing protease inhibitors more often reported nausea/vomiting, fatigue, but less often reported abdominal discomfort (all p's<0.01). Pts who used TDF/FTC/Ral for PEP less often reported diarrhea (p<0.01), but more often missed doses than Quad pts (p=0.021). Overall self-reported adherence with Quad PEP was 99.1%. No Quad pts became HIV-infected during the period of observation.
Conclusions: Quad PEP seems safe and well-tolerated after risky sexual exposures, with a minimal pill burden and self-reported high completion rates.
