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  • PEP Regimen

    Dear Doctor,

    3 months ago, I had exposure from a strange lady with vaginal sex and took PEP. Before taking PEP, I told doctor in my country that I am currently chronic hepatitis b and using tenofovir alafenamide 25mg (Hepbest from Mylan) as my kidney is not so well. Then he asked me to stop temporarily this medication and gave me the following PEP regimen (tenofovir alafenamide + emtricitabine+ dolutegravir ) for 30 days. But i search from internet and i found that TAF is not yet approved in PEP regimen and only for HIV treatment. It seems that only TDF (300mg) approved for used in PEP. So i have a question, the regiment that doctor gave to me was the correct one?

    I am asking this as may be in the future i have exposure again and if doctor keep continue to give me this regimen and i dont know if this PEP regimen can stop the infection.

    Thanks doctors

    BuBu
    Last edited by Bubu; 01-07-2021, 05:20 PM.

  • #2
    Hi Bubu,

    You are right that TDF is indeed not approved for PEP. Matter of fact is none of the HIV drugs are meant for PEP and use of these medications for PEP is off-label.

    However, TDF and TAF are eventually metabolized into the same active compound (Tenofovir diphosphate) in the cell so they are interchangeable with each other.

    Your regiment should work for PEP as it is almost identical to the guidelines given by WHO and USPHS, which is TDF/ETC/DOL.

    Regards

    Comment


    • #3
      Dear Doctor,

      Thanks for your feedback.

      Then i understand from your comment that there is no specific labelled drugs designed for PEP. We are using drugs of HIV treatment for PEP as off-label??

      I also want to use PrEp (TAF/FTC) due to my problem of kidney but i am confused that this only for MSN. But what is different between man on top in MSN and man on top in vaginal sex then. In both situation, a man insert penis into a hole then

      Thanks Doctor

      Comment


      • #4
        Hi Bubu,

        TAF/FTC is approved for daily dosing for PREP but not on-demand dosing.

        In theory there shouldn't be any difference. However, there is too little data on On-demand dosing for heterosexual and bisexual men, and hence On-Demand dosing is only recommended for MSM.

        Regards

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