Partial post-exposure protection by topical inserts containing tenofovir alafenamide fumarate/elvitegravir in a macaque model of rectal SHIV infection.

Makarova, Natalia; Singletary, Tyana; Peet, M Melissa; Kelley, Kristen; Johnson, Ryan; Agrahari, Vivek; Mendoza, Maria; Pan, Yi et al. · J Infect Dis · 2025

basic_science · Level V

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Abstract

On-demand topical inserts for HIV prevention may be a good option for people who have a low frequency of sexual activity. We recently demonstrated in a preclinical macaque model that rectal application of inserts containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) conferred protection against SHIV infection (93% efficacy) when applied as pre-exposure prophylaxis (PrEP) 4 hours before SHIV exposure. Here, we show that the same inserts provide significant post-exposure protection (82.9% efficacy) when applied four hours after SHIV exposure. Our findings further support the ongoing clinical development of TAF/EVG inserts for on-demand HIV prevention.