{"id":49351,"date":"2024-11-26T11:53:33","date_gmt":"2024-11-26T11:53:33","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=49351"},"modified":"2025-01-14T11:23:06","modified_gmt":"2025-01-14T11:23:06","slug":"europe-recommends-everyone-can-start-oral-prep-with-a-double-dose-to-get-rapid-protection-within-two-hours","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/49351","title":{"rendered":"Double dose start for oral PrEP in new EACS guidelines \u2013 rapid protection in two hours"},"content":{"rendered":"
\"\"

Laura Levi presenting updates to EACS PrEP guidelines at HIV Glasgow 2024.<\/p><\/div>\n

Simon Collins, HIV i-Base<\/strong><\/p>\n

The latest update to the European HIV guidelines from EACS, released at the HIV Congress in Glasgow, includes a new recommendation that everyone should start PrEP with a double dose. [1, 2]<\/strong><\/p>\n

This is irrespective of sex, gender or whether subsequent dosing will be daily or on-demand.<\/p>\n

The recommendation is based on providing rapid protection (within two hours) and is based on pharmacokinetic and pharmacodynamic studies. In last year’s guidelines, starting with a double dose was only recommended for cisgender men using on-demand 2:1:1 dosing. Otherwise, daily dosing for seven days was recommended for everyone else before relying on protection from daily PrEP.<\/p>\n

The new guidelines still only recommend 2:1:1 dosing for cisgender men (and by implication transgender women, based on IPERGAY), with everyone else needing to continue daily PrEP for seven days before stopping.<\/p>\n

This technically means that on-demand dosing should also be a new option for cisgender women using 2:7 dosing as recently recommended in the UK. However, this option is not proactively stated, and when the panel were asked directly about 2:7 on-demand dosing for women, no one could confidently reply. [3]<\/p>\n

This might have been because the panelists hadn’t been personally involved in that section, but a case study by Jean-Michel Molina the day before had recommended 2:7 on-demand dosing for women. [4]<\/p>\n

This year EACS are more confident to recommend that oral F\/TAF could be used whenever F\/TDF is not appropriate and that cabotegravir-LA can be considered when available.<\/p>\n

They also recommend that regularly taking at least four doses of oral PrEP every week provides a high level of protection for both women and men, whereas daily dosing was previously needed.<\/p>\n

comment<\/h3>\n

These dosing recommendations are similar to the UK BASHH\/BHIVA draft recommendations released in October 2024. [5]<\/strong><\/p>\n

Making oral PrEP more practical, easier to plan and less stringent will hopefully increase the uptake among women.<\/strong><\/p>\n

The new guidelines still need to take care however to clarify dosing recommendations for transgender and non-binary people and even references to transgender women are not always consistent.<\/strong><\/p>\n

Please see the full guidelines for details, which also include a new section on chemsex.<\/strong><\/p>\n

References<\/p>\n

    \n
  1. European AIDS Clinical Society (EACS). EACS HIV Guidelines 2024, v12.1.
    \nwww.eacsociety.org\/guidelines\/eacs-guidelines<\/a><\/li>\n
  2. The guidelines can only now be viewed using the EACS guidelines app or online:
    \n<\/span>    eacs.sanfordguide.com<\/a><\/li>\n
  3. Ambrosioni J et al. Guidelines Session: 2024 Update and CV Risk Recommendations. Plenary session, HIV Glasgow 2024. Wednesday 13 November 2024.
    \n    virtual.hivglasgow.org\/programme\/prep-ing-future<\/a> (webcast)
    \n<\/span><\/li>\n
  4. Molina J-M. Clinical case study 1. HIV Glasgow 2024. Tuesday 12 November.<\/li>\n
  5. Major update of UK PrEP guidelines online for public consultation.
    \n    i-base.info\/htb\/48804<\/a><\/li>\n<\/ol>\n

    This report was first published on 14 November 2024.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base The latest update to the European HIV guidelines from EACS, released at the HIV Congress in Glasgow, includes a new recommendation that everyone should start PrEP with a double dose. [1, 2] This is irrespective of …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,23,10],"tags":[337],"class_list":["post-49351","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-guidelines","category-transmission-and-prevention","tag-hiv-17-glasgow-2024"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/49351","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=49351"}],"version-history":[{"count":5,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/49351\/revisions"}],"predecessor-version":[{"id":50065,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/49351\/revisions\/50065"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=49351"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=49351"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=49351"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}