Discordant HIV Status and Conception: Potential Use for PrEP
Discordant HIV Status and Conception: Potential Use for PrEP
Hello. This is Dr. Paul Sax from Brigham and Women's Hospital and Harvard Medical School. Today I would like to talk about the recent Food and Drug Administration advisory panel meeting that looked at tenofovir/FTC for preexposure prophylaxis (PrEP). Not surprisingly, the advisory panel voted in favor of approving tenofovir/FTC for this purpose because studies have shown that if patients take it, then the combination of drugs is effective in preventing HIV.
What I want to focus on is a relatively undiscussed potential use of this drug: the use of tenofovir/FTC for assisting serodiscordant heterosexual couples in safely having children. I thought about this because of a nice study that was done in Switzerland, led by Vernazza [as well as commentary on that study].
He studied 53 serodiscordant couples in whom the man was infected and the woman wasn't. The men were all receiving suppressive antiretroviral therapy and the women were instructed to take PrEP around the time of potential conception. Without using any barrier methods, there were no transmissions and a 75% success rate in pregnancy.
Obviously we can never say that such an intervention is going to be 100% safe, but I would say that this particular approach has a lot to recommend it, especially in settings where sperm-washing, in vitro fertilization, and other reproductive technologies are either too expensive, not available, or just not desired by the couple. Couples should be given this information because this is potentially a way of conceiving more safely than unprotected non-PrEP-based intercourse.
That is something to think about, the potential use of PrEP for preventing transmission in couples who want to get pregnant. I have discussed this further on my blog, HIV and ID Observations. At the bottom of this video, you can see the specific references that I have alluded to.
Thank you very much.
Hello. This is Dr. Paul Sax from Brigham and Women's Hospital and Harvard Medical School. Today I would like to talk about the recent Food and Drug Administration advisory panel meeting that looked at tenofovir/FTC for preexposure prophylaxis (PrEP). Not surprisingly, the advisory panel voted in favor of approving tenofovir/FTC for this purpose because studies have shown that if patients take it, then the combination of drugs is effective in preventing HIV.
What I want to focus on is a relatively undiscussed potential use of this drug: the use of tenofovir/FTC for assisting serodiscordant heterosexual couples in safely having children. I thought about this because of a nice study that was done in Switzerland, led by Vernazza [as well as commentary on that study].
He studied 53 serodiscordant couples in whom the man was infected and the woman wasn't. The men were all receiving suppressive antiretroviral therapy and the women were instructed to take PrEP around the time of potential conception. Without using any barrier methods, there were no transmissions and a 75% success rate in pregnancy.
Obviously we can never say that such an intervention is going to be 100% safe, but I would say that this particular approach has a lot to recommend it, especially in settings where sperm-washing, in vitro fertilization, and other reproductive technologies are either too expensive, not available, or just not desired by the couple. Couples should be given this information because this is potentially a way of conceiving more safely than unprotected non-PrEP-based intercourse.
That is something to think about, the potential use of PrEP for preventing transmission in couples who want to get pregnant. I have discussed this further on my blog, HIV and ID Observations. At the bottom of this video, you can see the specific references that I have alluded to.
Thank you very much.
Source...