Hi Sandy,
The current package insert recommendations (and CDC guidelines) say to check an HIV test before EACH Apretude injection, and this should likely be an HIV RNA test, either quantitative or qualitative. The reasoning for this is that patients on PrEP who do develop HIV infection may have a delay in developing HIV antibodies, due to the immune system being exposed to a much lower quantity of virus. Therefore, if someone on Apretude (or Descovy or Truvada) has a falsely negative HIV Ab or Ab/Ag test, there may be enough time for the virus to develop resistance to the medication(s) in a non suppressive regimen. We certainly don't want patients to develop INSTI resistance, so I feel strongly that we should follow this recommendation. So maybe you could help guide the ID docs in your area who are not doing this. One problem with this strategy is the added cost, and some insurances may not fully cover the cost of an HIV RNA assay. Hope this helps.
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Adam Zweig
AIDS Healthcare Foundation
San Diego CA
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Original Message:
Sent: 08-22-2022 16:46
From: Sandy Tzaferos
Subject: Apretude & HIV test
It is my understanding that prior to each Apretude injection, a patient should be tested for HIV. We dispense Apretude to physicians' offices to administer. Some of our ID physicians are testing patients quarterly, as they did with the po PrEP and they insist this is acceptable. Can someone give me guidance on this? Thanks!
Sandy Tzaferos, PharmD
MediLink RxCare
609-226-6001