Tenofovir Alafenamide for HIV Preexposure Prophylaxis
Authors: Douglas S. Krakower, Demetre C. Daskalakis, Judith Feinberg, Julia L. Marcus
Journal: Annals of Internal Medicine (2020)

Letters7 July 2020Tenofovir Alafenamide for HIV Preexposure ProphylaxisDouglas S. Krakower, MD, Demetre C. Daskalakis, MD, Judith Feinberg, MD, and Julia L. Marcus, PhDDouglas S. Krakower, MDBeth Israel Deaconess Medical Center, Boston, Massachusetts (D.S.K.)Search for more papers by this author, Demetre C. Daskalakis, MDNew York City Department of Health and Mental Hygiene, New York, New York (D.C.D.)Search for more papers by this author, Judith Feinberg, MDWest Virginia University, Morgantown, West Virginia (J.F.)Search for more papers by this author, and Julia L. Marcus, PhDHarvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (J.L.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0301 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Brainard and McCallister assert that TAF–FTC has clinically meaningful renal and bone safety benefits over TDF–FTC for PrEP. They cite a meta-analysis confirming increased risk for renal AEs with TDF–FTC PrEP versus placebo or no PrEP (1), an open-label study of TDF–FTC PrEP for young men that found incomplete recovery of bone mineral density after PrEP discontinuation (2), and a pooled analysis of HIV treatment studies identifying higher rates of discontinuation after renal AEs with TDF versus TAF (3). We disagree that these studies show clinically meaningful benefits of TAF–FTC versus TDF–FTC for PrEP.First, the meta-analysis ...References1. Chou R, Evans C, Hoverman A, et al. Pre-Exposure Prophylaxis for the Prevention of HIV Infection: A Systematic Review for the U.S. Preventive Services Task Force. U.S. Preventive Services Task Force. 2019. Google Scholar2. Havens PL, Perumean-Chaney SE, Patki A; et al;. Changes in bone mass after discontinuation of preexposure prophylaxis with tenofovir disoproxil fumarate/emtricitabine in young men who have sex with men: extension phase results of Adolescent Trials Network protocols 110 and 113. Clin Infect Dis. 2020;70:687-691. [PMID: 31179503] doi:10.1093/cid/ciz486 CrossrefMedlineGoogle Scholar3. Gupta SK, Post FA, Arribas JR, et al. Renal safety of tenofovir alafenamide vs. tenofovir disoproxil fumarate: a pooled analysis of 26 clinical trials. AIDS. 2019;33:1455-1465. [PMID: 30932951] doi:10.1097/QAD.0000000000002223 CrossrefMedlineGoogle Scholar4. U.S. Food and Drug Administration. FDA briefing document: meeting of the Antimicrobial Drugs Advisory Committee. 7 August 2019. Accessed at www.fda.gov/media/129607/download on 12 March 2020. Google Scholar5. Walensky RP, Horn T, McCann NC, et al. Comparative pricing of branded tenofovir alafenamide–emtricitabine relative to generic tenofovir disoproxil fumarate-emtricitabine for HIV preexposure prophylaxis. A cost-effectiveness analysis. Ann Intern Med. 2020;172:583-590. [PMID: 32150602]. doi:10.7326/M19-3478 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Beth Israel Deaconess Medical Center, Boston, Massachusetts (D.S.K.)New York City Department of Health and Mental Hygiene, New York, New York (D.C.D.)West Virginia University, Morgantown, West Virginia (J.F.)Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (J.L.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3337. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTenofovir Alafenamide for HIV Preexposure Prophylaxis: What Can We DISCOVER About Its True Value? Douglas S. Krakower , Demetre C. Daskalakis , Judith Feinberg , and Julia L. Marcus Tenofovir Alafenamide for HIV Preexposure Prophylaxis Diana Brainard and Scott McCallister Metrics Cited byMind the Gap: HIV Prevention Among Young Black Men Who Have Sex with Men 7 July 2020Volume 173, Issue 1Page: 78KeywordsBoneBone densityDisclosureHIVHIV preventionPreexposure prophylaxisRenal diseasesSafetyWeight gainYoung adults ePublished: 7 July 2020 Issue Published: 7 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...