Evidence map›Paper›PMID 35474481›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022

Characterizing HIV-Preventive, Plasma Tenofovir Concentrations-A Pooled Participant-level Data Analysis From Human Immunodeficiency Virus Preexposure Prophylaxis Clinical Trials.

Maria Garcia-Cremades, Katarina Vučićević, Craig W Hendrix, Priya Jayachandran, Leah Jarlsberg, Robert Grant, Connie L Celum, Michael Martin, Jared M Baeten, Jeanne Marrazzo and 5 more

Open access · greenAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 3 countries.

Maria Garcia-CremadesDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA.
Katarina VučićevićDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA.
Craig W HendrixDivision of Clinical Pharmacology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Priya JayachandranDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA.
Leah JarlsbergDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA.
Robert GrantDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Connie L CelumDepartments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA.
Michael MartinCenters for Disease Control and Prevention, National Center For HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA.
Jared M BaetenDepartments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, Washington, USA.
Jeanne MarrazzoDivision of Infectious Diseases, University of Alabama at Birmingham Medical Center, Birmingham, Alabama, USA.
Peter AndersonDepartment of Pharmaceutical Sciences, University of Colorado, Denver, Colorado, USA.
Kachit ChoopanyaBangkok Tenofovir Study Group, Bangkok, Thailand.
Suphak VanichseniBangkok Tenofovir Study Group, Bangkok, Thailand.
David V GliddenDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA.
Radojka M SavicDepartment of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA.
University of California, San Francisco · USUniversity of Washington · USJohns Hopkins University · USMinistry of Public Health · THUniversity of Alabama at Birmingham · USUniversity of Belgrade · RSUniversity of Colorado Denver · US

Funding

Chemoprophylaxis for HIV Prevention in Men SupplementU01AI064002 · NIAID · J. DAVID GLADSTONE INSTITUTES · PI GRANT, ROBERT M. · 2005 to 2011
$41.3M
Statistical methods for clinical trials of novel PrEP agentsR01AI143357 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GLIDDEN, DAVID V. · 2018 to 2021
$483k
NIAID NIH HHS R01 AI143357NIAID NIH HHS U01 AI064002
6 · The paper itself

Abstract

backgroundDaily dosing of tenofovir disoproxil fumarate, with or without emtricitabine, has high efficacy in preventing human immunodeficiency virus (HIV) infection when individuals are adherent. The target protective plasma concentration of tenofovir (TFV), however, is not fully understood. The aim of this study is to estimate the protective TFV plasma concentration.

methodsParticipant data from TFV-based daily oral and topical active arms of phase 3 trials (iPrEx, VOICE, and Partners PrEP) were pooled (n = 2950). Individual specific risk scores (low and high risk) of acquiring HIV, based on an earlier placebo analysis, were created. Longitudinal TFV pharmacokinetics (PK), HIV outcome, individual risk scores and the effect of sex at birth data were integrated and analyzed using non-linear mixed effects models.

resultsAround 50% of the individuals were estimated to be adherent, which differed from self-reported adherence (∼90%) and large variation between longitudinal adherence patterns were identified. Following oral administration, the estimated protective TFV trough concentration was substantially higher in high-risk females (45.8 ng/mL) compared with high-risk males (16.1 ng/mL) and to low-risk individuals (∼7.5 ng/mL). Dosing simulations indicated that high-risk women require full adherence to maintain protective levels.

conclusionsUsing the largest PK-HIV outcome database to date, we developed a population adherence-PK-risk-outcome model. Our results indicate that high-risk females need higher levels of plasma TFV to achieve HIV protection compared with males. HIV protection exceeds 90% in all populations if daily adherence is achieved.

Indexed as

Anti-HIV AgentsHIV InfectionsPre-Exposure ProphylaxisClinical Trials, Phase III as TopicData AnalysisEmtricitabineFemaleHIVHumansMaleMedication AdherenceTenofovirAnti-HIV AgentsEmtricitabineTenofovirdrug protective plasma concentrationHIVHIV outcomepreexposure prophylaxis

Identifiers

PMID35474481
PMCPMC10139701
OpenAlexW4225006687

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.