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A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?
Version 1
: Received: 2 May 2022 / Approved: 5 May 2022 / Online: 5 May 2022 (16:11:31 CEST)
How to cite:
Lew, J.; Yee, I. A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?. Preprints2022, 2022050051. https://doi.org/10.20944/preprints202205.0051.v1
Lew, J.; Yee, I. A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?. Preprints 2022, 2022050051. https://doi.org/10.20944/preprints202205.0051.v1
Lew, J.; Yee, I. A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?. Preprints2022, 2022050051. https://doi.org/10.20944/preprints202205.0051.v1
APA Style
Lew, J., & Yee, I. (2022). A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?. Preprints. https://doi.org/10.20944/preprints202205.0051.v1
Chicago/Turabian Style
Lew, J. and Ilias Yee. 2022 "A Reality We Have to Face in the Era of Tenofovir-Derived Pre-exposure Prophylaxis and Antiretroviral Therapy: A Paradigm Shift From the Reduction of HIV Risk to the Increased Risk of Cardiovascular Disease?" Preprints. https://doi.org/10.20944/preprints202205.0051.v1
Abstract
The introduction of tenofovir-derived prodrugs has revolutionised the prevention and management of HIV, which has coincided with 23% reduction in new HIV incidences globally. To date, there are two formulations of tenofovir-derived nucleoside reverse transcriptase inhibitor (NRTI): tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) and tenofovir alafenamide fumarate/emtricitabine (TAF/FTC). Although these prodrugs have shown favourable safety profile, their effects on cardiovascular health are differ from one another: TDF/FTC exhibits potential lipid-lowering effect, TAF/FTC demonstrates potential lipid-inducing effect, which is a major risk factor for cardiovascular diseases. However, this issue has not been previously elucidated, especially among the marginalised populations [lesbian, gay, bisexual and transgender (LGBT) and men who have sex with men (MSM)] who are likely be the main users of these prodrugs. This is of clinically significance as the cardiovascular health in these populations is often overlooked, in addition to a lack of appropriate cardiovascular risk prediction algorithm. Therefore, this review aims to (1) highlight the cardiovascular risks of tenofovir-derived prodrugs in the marginalized populations, and also to (2) establish the importance of having a cardiovascular risk prediction model that is specific to this particular populations so that their health management could be more comprehensive.
Keywords
Tenofovir; Pre-exposure prophylaxis; anti-retroviral therapy; cardiovascular disease; LGBT
Subject
Medicine and Pharmacology, Pharmacology and Toxicology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.