Truvada (emtricitabine/tenofovir) pre-exposure prophylaxis roll-out among South African university students: Lots of positives, but let us keep an eye on possible surprises

Abstract

Antiretroviral therapy (ART) has fundamentally altered the natural history of HIV/AIDS, sharply reducing HIV-related morbidity and prolonging longevity. However, there seems to be a resurgence in HIV infection rates in some parts of the world that has prompted consideration of pre-exposure prophylaxis (pre-EP) and vaccination. Despite their good viral suppression profiles, most drugs used as part of ART also have unwanted adverse drug reactions/effects (ADRs). In this article we acknowledge the utility of pre-EP in combating HIV transmission, but we also highlight the need to prepare for management of other unexpected outcomes such as ADRs and viral resistance, to ensure the success of the programme.

Efficacy, Adherence and Side Effects of PrEP for HIV-1 Prevention

“…For the musculoskeletal system, elevated creatine kinase was reported in up to 9% patients using Truvada. Decreased bone mineral density and bone fractures (Desai et al, 2017;Montjane, Dlamini, & Dandara, 2018;Mulligan et al, 2015) have also been reported, especially for people with vitamin D 3 deficiency, intake of Truvada would cause decrease of bone mineral density. Supplementation of vitamin D was suggested for PrEP users (Havens et al, 2019;Havens et al, 2019;Nanayakkara et al, 2019).…”