Truvada® / Emtricitabin/Tenofovirdisoproxil

• Emtricitabin: Is activated to emtricitabin triphosphate in the cell and inhibits HIV reverse transcriptase
• Tenofovir: Is activated to Tenofovir diphosphate and also blocks reverse transcriptase

Protection mechanism:

• The active ingredients are enriched in the cells that use HIV as an entry gate
• In contact with HIV, the virus propagation is immediately blocked
• The virus cannot spread in the body
• An infection is prevented

Protection effect:

• Daily intake: > 99 % protection against HIV
• Full protection in anal traffic: after 7 days daily intake
• Full protection in vaginal traffic: after about 20 days daily intake

• HIV-negative persons with increased HIV risk
• Men who have sex with men (MSM) and changing partners
• heterosexual persons with HIV-positive partner (without virus load suppression)
• People who do sex work
• People with changing sexual partners and inconsistent condom use
• People with recurring STIs

Provisions:

• Confirmed negative HIV test (before!)
• Kidney function in standard range (GFR > 60 ml/min)
• Regular medical checks (every 3 months)

Not suitable:

• People with HIV infection (PrEP is NO HIV therapy!)
• Restricted kidney function (GFR < 60 ml/min)
• Acute HIV infection or unclear HIV status

Every PrEP (standard):

• 1 tablet (Emtricitabin 200 mg / Tenofovir 245 mg) once a day

Running Time:

• Anal traffic: 7 days daily intake for full protection
• Vaginal traffic: approx. 20 days daily intake

**Event-based PrEP (for MSM only for anal exposure):* *

• 2 tablets 2–24 hours before sex
• 1 tablet 24 hours after the first dose
• 1 tablet 48 hours after the first dose
• Continue taking at least 2 days after the last risk contact

Adoption:

• 1 tablet daily, always at about the same time
• Independent meals
• Suck with water

Examinations every 3 months:

• HIV test (before each new prescription!)
• Renal function (Creatinine, GFR)
• STI screening (Syphilis, Gonorrhoe, Chlamydien)
• Hepatitis B status (before start)

Important notes:

• Never start without previous HIV test!
• In case of forgotten dose: as soon as possible repeat, then continue as usual
• PrEP does NOT protect against other STIs – condoms still recommended
• Renal function and hepatitis B status

**PrEP must not be accepted at:* *

• HIV infection (also suspect!) – Risk of resistance development!
• Sensitivity to Emtricitabin or Tenofovir
• Kidney function disorder (GFR < 60 ml/min)

Preview at:

• Chronic hepatitis B (travel of a hepatitis B-lare-up when decomposing!)
• osteoporosis or risk factors for bone mineral density loss
• simultaneous use of nephrotoxic drugs
• Liver disease

**Acid (1–10 %) in the first weeks:* *

• nausea (usually temporary, after 2–4 weeks better)
• Headaches
• diarrhea
• fatigue
• Squeeze

** Occasionally (0.1-1 %):* *

• Blowing
• Skin rash

Long-term side effects (same):

• Easy kidney function restriction (reversible after depletion)
• Low bone mineral loss (clinically not relevant)
• Increased liver levels

Contracted:

• Other Tenofovir-containing medicines (avoid double dose)
• At the same time with highly dosed Adefovir

Preview at:

• Nephrotoxic medicines (NSAR for continuous use, aminoglycosides)
• Ledipasvir/Sofosbuvir (Tenofovir mirrors can increase)
• Didanosine (increased toxicity)

No problem:

• Hormonal contraception ( pill, hormone spiral etc.)
• Most popular medicines
• Alcohol (measures)