Antiretrovirals for prophylaxis against COVID-19; a comprehensive literature review

J Clin Pharmacol. 2020 Nov 20. doi: 10.1002/jcph.1788. Online ahead of print.

Abstract

Although people living with human immunodeficiency virus(PLWH) and other comorbidities are expected to experience griever consequences with COVID-19, recent cohort studies do not indicate this. Antiretrovirals(ARVs) might have a prophylactic role in these patients. The purpose of this study is to review the most recently published articles on the possible role of ARVs for pre or post-exposure prophylaxis against COVID-19. From June to October 2020, we searched scientific databases using specific keywords to identify ongoing trials or articles published before October 2020 investigating any subgroups of ARVs for prophylaxis against COVID-19. Apart from molecular docking studies, in vitro, animal, and human studies are very limited for evaluating the prophylactic role of ARVs against SARS-CoV-2 infection. According to our findings, there is no definite evidence to support use of protease inhibitors for this purpose, despite the promising results of molecular studies and limited clinical evidence for ritonavir boosted lopinavir, darunavir, and nelfinavir when used early in the course of the disease. Nucleotide/nucleoside reverse transcriptase inhibitors(NRTI) also have shown binding affinity to SARS-CoV-2 main enzymes in molecular, in vitro and animal studies. NRTIs like tenofovir and emtricitabine might exhibit prophylactic role against SARS-CoV-2 infection. In conclusion, currently there is no evidence to justify the use of ARVs for prophylaxis against COVID-19. This article is protected by copyright. All rights reserved.

Keywords: Antiretroviral drugs; COVID-19; HIV; Prophylaxis; SARS-CoV-2.

Publication types

  • Review