PEP Regimen with Rilpivirine Tolerable Among Healthcare Workers
NEW ORLEANS, LA—Healthcare workers at risk of HIV infection due to occupational exposure responded well to post-exposure prophylaxis (PEP) with a regimen that included rilpivirine, a newer generation antiretroviral agent, in combination with tenofovir and lamivudine, a study from Thailand reported at IDWeek.
To date, the primary challenge in achieving the best efficacy of a 4-week course of a triple-drug PEP regimen is drug-related adverse results, preventing the course from being completed, noted Vee Chavapong, MD, of the Department of Internal Medicine at the Prince of Songkla University, Songkhla, Thailand.
Among patients with HIV, rilpivirine, a once-daily non-nucleoside reverse transcriptase inhibitor (NNRTI), is generally well tolerated with tenofovir and lamivudine. However, no tolerability data were available for the agent when used in subjects without HIV.
The multicenter observational prospective study enrolled 41 healthcare workers between May 2015 and March 2016; 31 (75.6%) were female. Mean age was 28.6 years (range, 22-60 years). The most frequently exposed group were nurses and nurse assistants (39%), with percutaneous injury (68.3%) the most common type of exposure.
Among the 41 healthcare workers exposed to HIV, serological status was determined in 17 (41.4%); 11 (26.8%) were exposed to the HIV-infected source.
All received tenofovir-lamivudine-rilpivirine for PEP within 72 hours and 33 (80.5%) completed the 4-week course.
Three (7.3%) discontinued PEP due to nausea and vomiting; 4 (9.7%) forgot to take medicine at least 1 day of 4 weeks; and 1 (2.4%) decided to withdraw because the source patient had an unknown HIV serological status.
The most common adverse effects reported were nausea or vomiting (43.9%), dizziness (29.2%), and fatigue (14.6%), with most adverse events mild and self-limited.
No seroconversions were observed.