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

Preventive Efficacy of Tenofovir/Emtricitabine Against Severe Acute Respiratory Syndrome Coronavirus 2 Among Pre-Exposure Prophylaxis Users.
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DOI:
10.1093/ofid/ofaa455
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发表时间:
2020-11
影响因子:
4.2
通讯作者:
Sandoval Study Group
Sandoval Study Group
中科院分区:
医学3区
文献类型:
--
作者:
Ayerdi O;Puerta T;Clavo P;Vera M;Ballesteros J;Fuentes ME;Estrada V;Rodríguez C;Del Romero J;Sandoval Study Group

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替诺福韦/恩曲他滨(FTC)在人类免疫缺陷病毒阴性人群中对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的预防作用尚不清楚。本研究的目的是分析暴露前预防(PrEP)、富马酸二异丙酯/FTC(TDF/FTC)或替诺福韦艾拉酚胺(TAF)/FTC使用者中COVID-19的血清阳性率和临床表现,并与对照组进行比较。从2020年5月11日至2020年6月27日,在未使用PrEP的男男性行为者和跨性别女性(第1组; n = 250)以及使用TDF/FTC(n = 409)或TAF/FTC(n = 91)的PrEP使用者(第2组; n =500)中进行了SARS-CoV-2抗体血清阳性率的观察性描述性研究。       向所有参与者提供了一份结构化问卷,收集了有关待分析变量的信息,然后进行了SARS-CoV-2免疫球蛋白G抗体检测(荧光微粒免疫测定法)。SARS-CoV-2的血清阳性率在未使用PrEP的组中为9.2%(95%置信区间[CI],5.9-13.5),在使用PrEP的组中为15.0%(95% CI,12.0-18.4)(P = 0.026)。  在TDF/FTC使用者中为14.7%(95% CI,11.4-18.5),在TAF/FTC使用者中为16.5%(95% CI,9.5-25.7)(P = 0.661)。  在SARS-CoV-2检测呈阳性并接受PrEP的患者中,57.4%表现出症状,而对照组为78.3%(P = 0.070)。  在TDF/FTC使用者中,这一数字为53.3%,在TAF/FTC使用者中,这一数字为73.3%(P = 0.100)。  对照组的症状持续时间为11.5天,PrEP使用者为9.0天(P =.116),TDF/FTC使用者为7.0天,TAF/FTC使用者为13.0天(P =.100)。    PrEP、TDF/FTC或TAF/FTC使用者对SARS-CoV-2的血清阳性率高于对照组。在临床表现方面没有发现统计学显著差异。PrEP使用者应使用与普通人群相同的预防措施。PrEP、TDF/FTC或TAF/FTC使用者对SARS-CoV-2的血清阳性率高于对照组。两组临床表现差异无统计学意义。PrEP使用者应使用与普通人群相同的预防措施。
The preventive effect that tenofovir/emtricitabine (FTC) could have against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human immunodeficiency virus-negative people is unknown. The objective of this study was to analyze the seroprevalence and clinical manifestations of COVID-19 among users of pre-exposure prophylaxis (PrEP), disoproxil fumarate/FTC (TDF/FTC), or tenofovir alafenamide (TAF)/FTC and to compare it to that of a control group. An 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 (Group 1; n = 250) and PrEP users with TDF/FTC (n = 409) or TAF/FTC (n = 91) (Group 2; n = 500) was conducted from May11, 2020 to June 27, 2020. All participants were provided with a structured questionnaire that collected information on the variables to be analyzed, and testing for immunoglobulin G antibodies to SARS-CoV-2 (chemiluminescent microparticle immunoassay) was then carried out. The seroprevalence of SARS-CoV-2 was 9.2% (95% confidence interval [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 = .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 = .661). In those who tested positive for SARS-CoV-2 and receiving PrEP, 57.4% manifested symptoms, compared with 78.3% in the control group (P = .070). In users of TDF/FTC the figure was 53.3% and in users of TAF/FTC the figure was 73.3% (P = .100). The duration of symptoms was 11.5 days in the control group, 9.0 days in PrEP users (P = .116), 7.0 days in users of TDF/FTC, and 13.0 days in users of TAF/FTC (P = .100). 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. The PrEP users should use the same prevention measures as those indicated for the general population. 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 clinical manifestations. PrEP users should use the same prevention measures as those indicated for the general population.
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