Partial post-exposure protection by topical inserts containing tenofovir alafenamide fumarate/elvitegravir in a macaque model of rectal SHIV infection

J Infect Dis. 2025 Dec 4:jiaf611. doi: 10.1093/infdis/jiaf611. Online ahead of print.

Abstract

On-demand topical inserts for HIV prevention may be a good option for people who have a low frequency of sexual activity. We recently demonstrated in a preclinical macaque model that rectal application of inserts containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) conferred protection against SHIV infection (93% efficacy) when applied as pre-exposure prophylaxis (PrEP) 4 hours before SHIV exposure. Here, we show that the same inserts provide significant post-exposure protection (82.9% efficacy) when applied four hours after SHIV exposure. Our findings further support the ongoing clinical development of TAF/EVG inserts for on-demand HIV prevention.

Keywords: Elvitegravir; HIV pre-exposure and post-exposure prophylaxis; Macaque models; Tenofovir alafenamide; Topical PrEP and PEP.