Preventive Efficacy of Tenofovir/Emtricitabine Against Severe Acute Respiratory Syndrome Coronavirus 2 Among Pre-Exposure Prophylaxis Users

Abstract

Background The preventive effect which tenofovir/emtricitabine could have against SARS-CoV-2 in HIV-negative people is unknown. The objective of this study was to analyse the seroprevalence and clinical manifestations of COVID-19 among users of PrEP, TDF/FTC or TAF/FTC, and to compare it to that of a control group. Methods Observational descriptive study of the seroprevalence of antibodies for SARS-CoV-2 among men who have sex with men and transgender women without use of PrEP(Group1;n=250) and PrEP users with TDF/FTC(n=409) or TAF/FTC(n=91) (Group2;n=500), conducted from 11-May-2020 to 27-Jun-2020. All were provided with a structured questionnaire which collected information on the variables to be analysed and testing for IgG antibodies to SARS-CoV-2 (CMIA) was then carried out. Results The seroprevalence of SARS-CoV-2 was 9·2%(95% CI: 5·9-13·5) in the group without PrEP and 15.0%(95% CI: 12·0-18·4) in the group with PrEP(p=0·026). Among users of TDF/FTC it was 14.7%(95% CI: 11·4-18·5) and in users of TAF/FTC it was 16·5%(95% CI: 9·5-25·7)(p=0·661). In those positive for SARS-CoV-2 receiving PrEP, 57·4% manifested symptoms compared to 78·3% in the control group (p=0·070). In users of TDF/FTC the figure was 53·3% and TAF/FTC 73·3%(p=0·100). The duration of symptoms was 11·5 days in the control group, 9·0 in PrEP users(p=0·116), 7·0 in users of TDF/FTC and 13·0 in users of TAF/FTC(p = 0·100). Conclusion Users of PrEP, TDF/FTC or TAF/FTC presented a higher seroprevalence to SARS-CoV-2 than the control group. No statistically significant differences were found in relation to clinical manifestations. PrEP users should use the same prevention measures as those indicated for the general population.

Antiretroviral drug activity and potential for pre-exposure prophylaxis against COVID-19 and HIV infection

“…In addition, the top 3 scoring ligands for the Mpro, and the top 3 ligands for the RdRp were chosen based on their IFD docking scores, and by their known mechanism of action in HIV. We also added tenofovir to this analysis, despite being the 5 th ranked according to docking score, due to its reported in vitro activity in this paper, and proposed potential in several clinical trials (Ayerdi et al, 2020;Chien et al, 2020;Del Amo et al, 2020). These 7 top docked structures were used for further analyses due to these known properties and their simulated docking scores.…”

“…We chose the top scoring docked ligands; in addition, we considered their known mechanism in HIV. Further, we included tenofovir in the MD analysis, due to its effect in vitro and in vivo against SARS-CoV-2 (Ayerdi et al, 2020;Chien et al, 2020;Del Amo et al, 2020). Tables 1 and 2 show the top scored ligands and their Glide XP docking scores when docked to the Mpro and RdRp respectively.…”

“…All MD results not presented here are found in the supplemental material, including the ligand RMSF, radius of gyration, intramolecular hydrogen bonding, and SASA, MolSA and PSA. The RdRp docked with either abacavir, emtricitabine, tenofovir, or zidovudine was the selected structures used in further MD analyses based on their docking scores and reported in vitro, and in vivo (Ayerdi et al, 2020;Chien et al, 2020;Del Amo et al, 2020). The protein RMSD of all four were completely stable over the 250 ns simulation as determined by the Ca represented blue lines in Figure 7(a)-(d).…”

Pharmacological considerations for the treatment of COVID-19 in people living with HIV (PLWH)

“…Moreover, as TDF, TAF and FTC (with suggested molecular basis to prevent SARS-CoV-2 infection [ 70 , 71 , 74 ]) are components of the two approved medications for use as HIV pre-exposure prophylaxis (PrEP), their effect on the risk of COVID-19 is being evaluated in PrEP users [ 53 ]. Recently, an observational descriptive study conducted in Madrid found that users of PrEP presented a higher seroprevalence to SARS-CoV-2 than the control group, with no statistically significant differences in relation to COVID-19 clinical manifestations [ 78 ].…”

Osobennosti techeniya sochetannoj infekcii VICH/SARS-CoV-2 v usloviyah pandemii

“…Испанскими исследователями показана более высокая распространенность SARS-CoV-2 среди пользователей предэкспозиционной профилактики на основе тенофовира дизопроксилфумарата или тенофовира алафенамида и эмтрицитабина (TDF/TAF + FTC) без существенных различий в клинических проявлениях по сравнению с контрольной группой [45], что опровергает гипотезу о протективном эффекте тенофовира в отношении инфекции, вызываемой SARS-CoV-2 [42]. В нескольких других работах также есть данные о большей доле ВИЧ/SARS-CoV-2-коинфицированных пациентов, получающих АРВТ на основе TDF, по сравнению с ВИЧ-моноинфицированными пациентами [17,22].…”