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  Glasgow HIV
28 - 31 October 2018
Glasgow, UK
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How safe is PrEP? An analysis of the safety of TDF(/FTC) as PrEP
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An analysis of the safety
of TDF(/FTC) as PrEP

This poster poster pdf used as basis for oral talk by Andrew Hill. And paper published attached.
Victoria Pilkington1, Andrew Hill2, Sophie Hughes3,
Nneka Nwokolo4, Anton Pozniak4,5
1Faculty of Medicine, Imperial College London, United Kingdom; 2Department of Pharmacology and Therapeutics, University of liverpool, UK;
3 MetaVirology Ltd Research, London UK; 4 Chelsea and Westminster Hospital, 56 Dean street, London UK; 5 London school of hygiene and Tropical Medicine, london UK
Reported by Jules Levin
Glasgow 2018 Oct 27-31
Study published, here is published pdf which says this in Strengths & Limitations section: Trials have inherent limitations in that participants may have been excluded if they showed a higher baseline risk of renal or bone disease, biasing potential findings. An important limitation may be low adherence in several of the trials, which could dilute the rate of drug-related adverse events. Jules
Full article: http://viruseradication.com/journal-details/How_safe_is_TDF-FTC_as_PrEP^_A_systematic_review_and_meta-analysis_of_the_risk_of_adverse_events_in_13_randomised_trials_of_PrEP/
from Jules: a few points: some recent studies over past few years have reported in abstracts at conferences increased kidney marker dysfunction for some on PrEP and risk factors include older age - those with older age may be more likely to have kidney dysfunction markers on PrEP; those with a baseline predisposition for kidney dysfunction, markers; those with high adherence may be more at risk to have adverse kidney affects, and increased condomless sex may be resulting in increased STIs, perhaps longer duration of time on PrEP may be a factor. Perhaps non-daily use but use for selected brief times just for events like before sex or over a weekend may be safer but this needs a better look. This meta analysis does not look at these factors.
Changes in Kidney Function Associated With Daily Tenofovir Disoproxil Fumarate/Emtricitabine for HIV Preexposure Prophylaxis Use in the United States Demonstration Project
CROI: Higher cumulative TFV/FTC levels in PrEP associated with decline in renal function - (02/26/16)






Figures: Meta-analyses of five adverse event end points; Risk difference of adverse event occurrence on PrEP versus control. Trials are stratified into subgroups by length of trial follow up (1year average).