| TDF-FTC | - Well tolerated.
- Most studied regimen and can be used in all populations.
- Can be administered as event-driven therapy for persons who engage only in anal sex (unless they have concurrent chronic HBV infection).
| - Can result in reduced kidney function.
- Can result in bone loss.
- For patients with chronic HBV, they are at risk for flare of their liver disease if therapy is discontinued.
| - TDF should not be used in persons with an eGFR <60.
- Patients require monitoring of creatinine on therapy.
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| TAF-FTC | - Well tolerated.
- Less bone and renal toxicity compared with TDF.
| - Should only be administered as daily therapy.
- Higher rates of mild triglyceride elevations and weight gain compared with TDF-FTC.
- Should not be used in those whose main risk for HIV is vaginal (frontal) sex or who inject drugs.
- Less experience compared with TDF, particularly in certain populations (eg, adolescents).
- For patients with chronic HBV, they are at risk for flare of their liver disease if therapy is discontinued.
| - Has not been well studied for PrEP in persons who engage in vaginal (frontal) sex, pregnant persons, or those who inject drugs.
- There are no data evaluating event-driven dosing in those taking TAF-FTC.
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| Cabotegravir LA | - Well tolerated.
- Administered every other month.
- Clinical trials suggest efficacy greater than TDF-FTC (possibly related to improved adherence).
- Can be considered for patients with conditions that are associated with an increased risk of adverse events with TDF-FTC or TAF-FTC (eg, those with reduced kidney function, bone disease)*.
| - Cabotegravir LA has a long half-life (drug may be detectable in blood for more than a year). An oral agent (TDF-FTC or TAF-FTC) is required for a period of time when discontinuing cabotegravir LA injections to reduce the risk of developing an integrase inhibitor-resistant strain if HIV infection is acquired when cabotegravir levels are suboptimal*.
- Future HIV treatment options (ie, use of an integrase strand transfer inhibitor) may be limited if HIV infection occurs and resistance to cabotegravir develops.
- Need to be near a center that administers cabotegravir LA so doses are not missed.
- Injection site reactions (generally mild).
| - For those who are concerned about side effects of cabotegravir LA, oral cabotegravir (30 mg once daily) can be administered for a 4-week lead-in period prior to initiating injections.
- There are only limited data in persons who are pregnant or who desire pregnancy.
- Cabotegravir LA has not yet been studied in persons who inject drugs.
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