Acriptega Cannot Be Used as Pre-Exposure Prophylaxis for HIV
Acriptega is NOT approved or recommended for HIV pre-exposure prophylaxis (PrEP). Acriptega is a fixed-dose combination antiretroviral therapy containing dolutegravir, lamivudine, and tenofovir disoproxil fumarate, designed for HIV treatment, not prevention.
The Only Approved PrEP Regimens
Tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) 300mg/200mg taken once daily is the sole recommended first-line PrEP regimen for all populations at risk of HIV acquisition, with proven efficacy exceeding 90% when adherence is maintained 1, 2. This combination has been validated in multiple placebo-controlled randomized trials demonstrating significant reduction in HIV acquisition across diverse populations 3.
Alternative PrEP Options (Limited Populations)
- Tenofovir alafenamide/emtricitabine (TAF/FTC) may be considered for men who have sex with men (MSM) with creatinine clearance 30-60 mL/min, osteopenia/osteoporosis, or age >50 years 1, 2
- TAF/FTC is NOT recommended for cisgender women as PrEP, as efficacy data in vaginal tissue are insufficient 1, 4
Why Acriptega Cannot Be Used for PrEP
The critical issue is that Acriptega contains lamivudine instead of emtricitabine, and includes dolutegravir—an integrase inhibitor not validated for PrEP 5. Current guidelines explicitly state:
- TDF/lamivudine is NOT recommended for PrEP 5
- Only TDF/emtricitabine has demonstrated efficacy in preventing HIV acquisition through validated clinical trials 3
- Using non-approved combinations risks inadequate protection and potential development of drug resistance if HIV infection occurs 6
The Danger of Misusing Treatment Drugs for Prevention
If Acriptega were inadvertently used for PrEP and the person acquired HIV infection, the dolutegravir component could lead to integrase inhibitor resistance, compromising future treatment options 6. Resistance typically occurs when PrEP-like regimens are initiated during undiagnosed acute HIV infection 6, 3.
Correct PrEP Prescribing
Pre-Initiation Requirements
- Combined HIV antibody/antigen testing (mandatory within 7 days before starting) 5, 1
- HIV RNA testing if acute infection suspected 5, 1
- Serum creatinine and estimated creatinine clearance 1, 2
- Hepatitis B surface antigen and hepatitis C antibody 1, 2
- STI screening (gonorrhea, chlamydia, syphilis) 1, 2
- Pregnancy testing for individuals of childbearing potential 1, 2
Monitoring During PrEP Use
- HIV testing every 3 months (combination antibody/antigen assay) 5, 1, 2
- Additional HIV testing at 1 month after initiation 1, 2
- STI screening every 3 months 5, 1, 2
- Creatinine assessment every 6 months (more frequently if baseline <90 mL/min or comorbidities present) 5, 1, 2
Critical Clinical Caveat
PrEP prescription should never exceed 90 days without interval HIV testing 5, 1. This prevents the catastrophic scenario of continuing PrEP in someone with undiagnosed HIV infection, which would constitute functional monotherapy or dual therapy and drive resistance 6, 3.