On-demand dosing for PrEP is highly effective in French expanded access programme
1 October 2017. Related: Conference reports, HIV prevention and transmission, IAS 9th Paris 2017.
Simon Collins, HIV i-Base
Results from the expanded access PrEP programme in France, provided continued efficacy of on-demand or daily dosing for PrEP.
This poster, presented by Eric Cua, included data on 2,805 people enrolled from January to December 2016 in an early access programme that covered more than 130 clinics nationally.
This was a high-risk group with 30% having had two or more STIs during the previous year. Approximately 11% had used PEP and 20% used recreational drugs. Median age of participants was 36 years (IQR: 30 to 44) and most (97.4%) were gay men. On-demand dosing was used by 59% of participants.
During 1100 patient years (PY) of follow up, there were four new HIV infections (rate 0.36/100 PY; CI95%: 0.07 to 7.20). Of these, 2/4 were acute HIV seroconversions without drug resistance that occurred before inclusion in programme. One case presented with HIV seroconversion at month 1 visit with a 500 copies/mL and a M184I mutation. The final case presented with seroconversion (with no resistance) two months after PrEP had been stopped (participant decision).
The study notes the high efficacy shown by these data in a real life setting, with the importance of early and continued monitoring given the risk of starting PrEP after recent infection or risk.
Full results from this study were published in the September 2017 edition of Lancet HIV. 
- Molina J-M et al. One-year experience with pre-exposure prophylaxis (PrEP) implementation in France with TDF/FTC. IAS 2017, 23–26 July 2017, Paris. Poster abstract WEPEC0939.
- Efficacy, safety, and effect on sexual behaviour of on-demand pre-exposure prophylaxis for HIV in men who have sex with men: an observational cohort study. Lancet HIV: 4(9); e402–e410 (September 2017).