Raltegravir-based HIV postexposure prophylaxis (PEP) in a real-life clinical setting: fewer drug–drug interactions (DDIs) with improved adherence and tolerability

Randomized controlled trial of the tolerability and completion of maraviroc compared with Kaletra® in combination with Truvada® for HIV post-exposure prophylaxis (MiPEP Trial)

“…Low completion rates of PEP have been reported in many settings; therefore PEP regimens with a more favourable tolerability profile may help in this regard [23][24][25][26]. Recent data suggest that another ritonavir-boosted PI, darunavir, may be better tolerated [27]. However all ritonavir-boosted PI-based combinations have a higher risk for drug-drug interactions than alternatives such as raltegravir or rilpivirin [28,29].…”

Safety and Tolerability of Once Daily Coformulated Bictegravir, Emtricitabine, and Tenofovir Alafenamide for Postexposure Prophylaxis After Sexual Exposure

“…33 Combinations of NRTIs and raltegravir for PEP demonstrated a high level of safety and tolerability, but regimen completion was suboptimal, because many participants discontinued the medication prematurely or did not remember to take the second dose of raltegravir in the twice daily regimen. 11,[34][35][36] The fixeddrug single-pill coformulation of elvitegravir, cobicistat, FTC, and TDF allowed for the use of a single daily pill for PEP, but seemed to have higher rates of gastrointestinal symptoms and fatigue than raltegravir-based regimens, which may have led to product discontinuation. 12,37,38 A subsequent study found that the fixed dose combination of elvitegravir, cobicistat, FTC and TAF was well-tolerated, 39 but the use of the pharmacological booster has raised concerns about drug-drug interactions.…”

Highlights from this issue

“…Finally, we welcome reader letters, and are pleased this month to publish on treatment for rectal chlamydia18 and Raltegravir for post-exposure HIV prophylaxis 19…”