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to Section One | to Arts & Entertainment
posted Friday, May 29, 2015 - Volume 43 Issue 22
PrEP reaches peak effectiveness after only one week, new study says

High effectiveness remains for one week after last dose
Section One
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PrEP reaches peak effectiveness after only one week, new study says

High effectiveness remains for one week after last dose

by Mike Andrew - SGN Staff Writer

When used as a PrEP drug, Truvada reaches its peak effectiveness after only five to seven daily doses, and remains effective for up to seven days after the last dose, according to a new study.

According to the research, published in the journal Clinical Infectious Diseases, one day on PrEP resulted in a 75% to 91% risk reduction, three days meant a 95% to 97% risk reduction, and five to seven daily doses of PrEP translated to a 98% to 99% risk reduction.

The presumed risk reduction stayed higher than 90% for seven days after the last dose.

In the study, researchers gave Truvada to 11 HIV-negative men and 10 HIV-negative women for 30 days. They then measured drug levels of the medication at days 1, 3, 7, 20, 30, 35, 45, and 60.

Nineteen of the participants completed all the study visits. Participants apparently adhered to the daily dosing schedule at a rate of 99%, according to pill counts, self-reports and a dosing calendar.

The research team sampled levels of the drug in the subjects' blood mononuclear cells (PBMCs), and compared their findings to drug levels estimated in previous research to correspond to varying degrees of protection against HIV.

Although the study included female participants, it was not meant to estimate how well PrEP dosing protects them or other groups, just men who have sex with men (MSM).

The iPrEx study used as the reference point for Truvada's effectiveness at various concentrations in PBMCs was only conducted among MSM and Transgender women.

The research also does not apply to so-called 'on demand' or 'intercourse-based' dosing schedules, which are being studied in the ongoing IPERGAY trials.

In those tests, subjects only take Truvada in the days before and after having sex. A major difference in such a dosing strategy is that it starts with a double dose at least 24 hours before sex, and ends with another double dose 48 hours after sex.

The present research only studied a dose of one pill per day, taken regardless of whether the subject planned to have sex.

On one of the crucial questions about PrEP's effectiveness, the study offered cautious optimism. The research showed that Truvada remained quite effective at preventing HIV infection for several days after discontinuing the medication. Nevertheless, researchers recommended starting PrEP about a week before the first possible exposure to HIV and staying on it for four weeks after the last potential exposure.

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PrEP reaches peak effectiveness after only one week, new study says

High effectiveness remains for one week after last dose

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