Pre-exposure prophylaxis during the SARS-CoV-2 pandemic: can PrEP prevent COVID-19-related symptoms?

Abstract

It has been speculated that some drugs can be used against SARS-CoV-2. As for antiretrovirals, the follow-up of pre-exposure prophylaxis (PrEP) users during the coronavirus disease 2019 (COVID-19) outbreak may help to understand the potential protective effect of PrEP against SARS-CoV-2. We aimed to identify associations between oral PrEP use and COVID-19-related symptoms self-reporting. Phone call interviews or digital investigation (through WhatsApp® or e-mail) about oral PrEP regular use, social distancing, exposure to suspected or confirmed cases of SARS-CoV-2 infection and COVID-19-related symptoms. Among 108 individuals, the majority were cisgender, white and gay men. Although most of the individuals engaged in social distancing (68.52%), they kept on taking PrEP (75.93%). Few people have had contact with suspected or confirmed cases of COVID-19 (12.04%), but some had COVID-19-related symptoms the month before the interview (27.78%) including rhinorrheoa (56.67%), cough (53.33%), asthaenia (50.00%) and headache (43.33%). Also, oral PrEP was associated with lower self-reporting COVID-19-symptoms (OR 0.26, 95% CI 0.07-0.96, P = 0.04; h = 0.92) even after controlling confounders as social distancing, age, body-mass index and morbidities. In our sample, the regular use of oral PrEP was associated with lower self-reporting of COVID-19-related symptoms during the outbreak in São Paulo, Brazil.

HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: Results from a prospective observational study in Germany

“…Young, socially and sexually active PrEP users as in our study cohort can be assumed to have a larger number of social contacts, and during the current pandemic this exposes them to an increased risk of contracting SARS-CoV-2 infection. Two components of PrEP, tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), have been earmarked as potential therapeutics against SARS-CoV-2 ( 25 ), but attempts to correlate oral use of PrEP and clinical manifestations of COVID-19 has yielded conflicting conclusions ( 26 – 28 ). The positive SARS-CoV-2 serostatus of two participants with continuous PrEP intake regimen in our study cohort suggest that TDF and FTC may not be an efficient prophylaxis for SARS-CoV-2 infection.…”

Immunologic Interplay Between HIV/AIDS and COVID-19: Adding Fuel to the Flames?

“…Interestingly, some observational studies reported a protective effect of certain antiretroviral drugs, namely tenofovir disoproxil fumarate/emtricitabine (TDF/FTC), against SARS-CoV-2 infection and COVID-19–related outcomes in both PLWH [ 13 , 26 , 27 ] and HIV pre-exposure prophylaxis (PrEP) users [ 28 , 29 ]. This potential protective effect is biologically plausible due to the ability of nucleotide analog reverse transcriptase inhibitors (NRTIs) to inhibit the SARS-CoV-2 RNA-dependent RNA polymerase [ 30 , 31 ].…”

Changes in Utilization of Birth Control and PrEP During COVID-19 in the USA: A Mixed-Method Analysis

“…What we do know, however, is that many individuals are continuing to engage in sexual behavior that could transmit HIV (Lehmiller et al, 2021 ; Stephenson et al, 2020 ) illustrating the continuing need for access to PrEP. Limited existing research on PrEP and COVID-19 suggests that the majority of PrEP users are maintaining PrEP use (Fernandes et al, 2020 ; Pampati et al, 2020 ). Ultimately, the existing studies about HIV risk behavior, PrEP, and COVID-19 suggest that understanding PrEP use patterns during the pandemic is crucial for understanding the health and well-being of PrEP users.…”