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Anti-HIV drug PrEP has 30% lower concentration levels in pregnant African adolescents and young women

Published on 10/03/20 at 10:59am
Photo by Tony Webster

Pregnant African adolescents and young women who took the HIV drug PrEP were found to have 30% lower levels of the drug in their system than others when taking it regularly.

Prep is an anti-HIV drug that requires the patient to take regular oral tablets. It is shown to reduce the risk of sexual HIV acquisition by more than 90% in men and women when taken daily. Women must take it more regular to get drug concentration protective levels in the female genital tract.

This was part of the NIH-funded IMPAACT 2009 study where 40 participants took PrEP under direct observation, confirming near-perfect adherence. PrEP drug levels were lower to a similar degree in the pregnant African adolescent girls and young women compared to American men and non-pregnant, non-lacating women who took PrEP daily under direct observation in an earlier study.

Anthony S. Fauci, Director of the National Institute of Allergy and Infectious Disease at NIH, said: “While taking PrEP daily as directed is important for everyone who receives it, these new data suggest daily adherence to PrEP will be especially critical for pregnant adolescents and young women. Additional research is needed to determine the level of protection that daily PrEP can provide this population.”

The lower drug concentration found in pregnant adolescents and young women does not necessarily mean there is a lower efficacy in this group, as a response to any drug follows a curve that rises from zero as the dose increases until the curve reaches a plateau where a range of doses achieves a sufficient response to the desired effect. The lower drug concentration could fall in this plateau.

Conor Kavanagh


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