From the Guidelines
Biktarvy is the preferred choice for post-exposure prophylaxis (PEP) among many doctors due to its high efficacy, excellent tolerability, and convenience of a single daily pill. The standard PEP regimen with Biktarvy is one tablet taken once daily for 28 days, ideally started within 72 hours of potential HIV exposure. Although the provided evidence from the 2020 recommendations of the international antiviral society-USA panel 1 focuses on preexposure prophylaxis (PrEP) and does not directly mention Biktarvy for PEP, the principles of antiretroviral therapy and the importance of adherence to a regimen support the use of a convenient, single-tablet regimen like Biktarvy. Key benefits of Biktarvy include:
- High efficacy against HIV
- Excellent tolerability with fewer side effects than older regimens
- Convenience of a single daily pill, which improves adherence to the full 28-day course
- Multiple mechanisms of action: bictegravir blocks HIV integrase enzyme, while emtricitabine and tenofovir alafenamide inhibit reverse transcriptase
- Minimal drug interactions compared to other options, making it suitable for most patients However, it's crucial to individualize PEP medication selection based on the specific exposure scenario, potential source patient's viral resistance patterns, and the patient's medical history.
From the Research
Reasons for Preference of Biktarvy for PEP
- High efficacy and safety profile: Studies have shown that Biktarvy is effective in preventing HIV infection after exposure, with a high barrier to resistance 2, 3.
- Well-tolerated: Biktarvy has been found to be well-tolerated, with fewer side effects compared to other PEP regimens 2, 4.
- Convenient once-daily dosing: Biktarvy is a single-tablet regimen that can be taken once daily, making it easier for patients to adhere to the treatment regimen 5, 4.
- Limited drug-drug interactions: Biktarvy has been shown to have limited drug-drug interactions, making it a suitable option for patients with other medical conditions or taking other medications 3, 4.
- High completion rate: Studies have found that patients taking Biktarvy for PEP have a high completion rate, with almost all participants completing the indicated regimen 2.
Benefits of Biktarvy for PEP
- Effective in preventing HIV infection: Biktarvy has been shown to be effective in preventing HIV infection after exposure, with none of the participants in the study becoming HIV-positive 2.
- Suitable for patients with renal impairment: Biktarvy can be used in patients with renal impairment, with a creatinine clearance of 30 mL/min or higher 4.
- No prior HLA-B5701 testing required: Biktarvy does not require prior HLA-B5701 testing, making it a suitable option for "rapid start" treatment 4.
- Active against HBV: Biktarvy contains tenofovir alafenamide and emtricitabine, which are active against hepatitis B virus (HBV), making it a suitable option for patients co-infected with HBV 4.