1544. HIV Following Oral Pre-Exposure Prophylaxis (PrEP) Initiation
Notice bibliographique
Résumé
Abstract Background Once-daily oral tenofovir-based combinations as pre-exposure prophylaxis (PrEP) are effective biomedical HIV prevention strategies. Still, low adherence and/or persistence can lead to decreased efficacy. This study describes the characteristics and HIV incidence in commercially-insured US oral PrEP users. Usage pattern results were previously presented. Methods This retrospective study used IQVIA™ PharMetrics Plus data (1/1/2015–3/31/2020) to identify adults newly initiated (index date) on emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) as daily PrEP. Users had ≥ 6 months (mos.) of continuous enrollment pre-index (baseline); those diagnosed with HIV or with antiretroviral therapy (ART) use during baseline were excluded. User characteristics were described during the baseline period. Users with both an HIV diagnosis and ART dispensing post-index were considered to have acquired HIV. A sensitivity analysis was conducted using ≥ 2 dispensings of ART on separate days to define HIV infection, regardless of documented HIV diagnosis. Time to HIV infection from the index date and from the latest PrEP dispensing was reported. A separate analysis without ≥ 6 mos. of continuous enrollment pre-index was performed. Results In total, 24,232 FTC/TDF users were identified (Table 1). Mean [median] length of follow-up was 504 [390] days. By 3 mos. after initiation, 0.3% of FTC/TDF users had acquired HIV, which increased to 0.5% by 12 mos. (Table 2). The mean [median] time to detected HIV infection from index was 235 [95] days, and from the latest PrEP dispensing was 149 [29] days. 60.3% of FTC/TDF users with an HIV diagnosis had PrEP on hand at the time HIV was detected. In the sensitivity analysis requiring only ≥ 2 ART dispensings, rates were slightly higher (3 mos., 0.4%; 12 mos., 0.7%). In the analysis which removed the 6-month pre-index coverage requirement (Table 3), rates were also higher (3 mos., 2.2%; 12 mos., 2.5%). Conclusion HIV diagnosis following oral PrEP initiation is infrequent with higher incidence in those whose first covered healthcare encounter coincides with PrEP initiation. That a majority diagnosed with HIV had PrEP available at time of detection suggests challenges unexplained by access. Further research is needed to limit HIV acquisition despite access to oral PrEP. Disclosures Aimee A. Metzner, PharmD, AAHIVP, ViiV Healthcare: Full-time employee (salary/benefits/etc.)|ViiV Healthcare: Stocks/Bonds Guillaume Germain, MSc, ViiV Healthcare: I am an employee of Analysis Group, a consulting company that received research funds from ViiV Healthcare to conduct this study. François Laliberté, MS, GSK: Grant/Research Support Alan Oglesby, MPH, GlaxoSmithKline: Employment|GlaxoSmithKline: Stocks/Bonds Heidi Swygard, MD, ViiV Healthcare: Employee of ViiV Healthcare|ViiV Healthcare: Stocks/Bonds Sean MacKnight, MScPH, ViiV: I am an employee of Analysis Group, a consulting company that received research funds from ViiV to conduct this study. Annalise Hilts, BA, ViiV (I am an employee of Analysis Group, a consulting company that received research funds from ViiV to conduct this study.): Grant/Research Support Mei Sheng Duh, MPH, ScD, Analysis Group, Inc.: Mei Sheng Duh is an employee of Analysis Group, Inc., a consulting company that received funding from GSK to conduct this study|ViiV Healthcare: Grant/Research Support
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».