Where Else Should PrEP Assessment Go?

As more agents expand the capability and variety of PrEP options, investigators consider what questions remain about the drug class.

With injectable pre-exposure prophylaxis (PrEP) options reaching the market for people at risk of HIV, clinicians will soon have the benefit of greater and more varied real-world data that could help refine the preventive agent’s role in mitigating HIV.

Where else may assessment go?

In the second segment of an interview with Contagion during IDWeek 2021, Raphael J. Landovitz, MD, MSc, of the UCLA Center for Clinical AIDS Research & Education, detailed the most pressing questions remaining in injectable PrEP analysis.

“Many of us have wondered what the long-term safety and tolerability of an injectable is going to be, so we are going to have an additional year of data we hope to present some time before IDWeek next year that will inform that,” he said.

Landovitz also highlighted ongoing testing of more sensitive algorithms for viral load testing that could help reduce risk of PrEP resistance in at-risk persons, the assessment of “direct to inject” strategy that does away with the general first-month oral PrEP lead-in regimen, as well as pursuit to better interpret the correlates between injectable PrEP and overall HIV protection.

“One of the almost biblical discussions that continue in the PrEP and prevention space is, ‘What’s the right measurement of a pharmacokinetic parameter that correlates best with protection?’” Landovitz said.

After, Landovitz touched on the pursuit of an HIV vaccine, which he believes may have recently benefited from innovations met in COVID-19 prevention.

“We’re 40 years on and we don’t have one yet, but I think the spectacular successes in the COVID-19 field with the mRNA platform and rapid vaccine development has sort of re-energized interest in vaccines for HIV,” he said.