Appropriate medicines: options for pre-exposure prophylaxis

Overview

In March 2016, WHO and UNAIDS jointly convened a technical group of experts in antiretroviral (ARV) pharmacology and HIV pre-exposure prophylaxis (PrEP) clinical research to provide clarifications related to three specific implementation concerns for countries regarding the appropriate use of PrEP drug regimens:

• possible use of lamivudine (3TC) as an alternative to emtricitabine (FTC) for oral PrEP containing tenofovir disoproxil fumarate (TDF),
• possible use of TDF alone for oral PrEP, and
• safety of PrEP during pregnancy and breastfeeding, in terms of both maternal and fetal/newborn outcomes.

The technical consultation reviewed a spectrum of evidence, including animal studies, human pharmacology and randomized clinical trials on PrEP as well as indirect evidence from HIV treatment studies.