Question

My friend was just prescribed Triumeq as PrEp after being on Truvada for 6 months due to his decreased bone density. Is that common to prescribe Triumeq for negative patients?

Answer

Hello and thanks for posting your interesting question about PrEP.

HIV pre-exposure prophylaxis (PrEP) is a very highly effective way to prevent infection in people at risk. The only well-studied and approved medication for PrEP is tenofovirDF/emtricitabine (or Truvada; TDF/FTC). It's generally very well tolerated, we have millions of excellent patient-years of experience with using the drug in people living with HIV, and it has a well characterized safety/toxicity profile- namely issues with kidney and bone toxicity. For these later reasons, Truvada may not be for everyone- either for PrEP or for treatment- and it sounds like your friend may have issues with osteoporosis (low bone mineral density).

In short, no. It's not common to use Triumeq for PrEP. While it stands to reason that Triumeq (abacavir/lamivudine/dolutegravir) might work as HIV PrEP, we simply don't know. Triumeq is a very well tolerated (I'll assume that your friend's care provider has run the requisite HLA B5701 genetic test that assesses risk of serious allergic reaction to abacavir) and highly effective treatment for chronic HIV infection, but has not been studied for PrEP.

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