Hi all,
I’d really appreciate your advice on this.
I’m considering starting PrEP (Tenofovir Disoproxil) to prevent HIV. I had an acute Hepatitis B infection about two years ago, which cleared on its own within a couple of months.
Last year, I tested negative for Hep B but didn’t have antibodies, so I was vaccinated immediately. Then 2months later after that, my immunity is at 23.
Recently, I visited the sexual health clinic who is aware of my history and has prescribed PrEP. According to the doctor, it’s considered safe for me to use daily PrEP or the 2-1-1 regimen.
However, I just want to double-check: is it truly safe to take PrEP in my case? I understand that stopping PrEP can be risky for people with chronic Hep B due to the potential for reactivation.
Are there any documented cases of reactivation in people who had a past acute Hep B infection (not chronic) after stopping PrEP?
Thanks so much for your guidance and any insights you can share.
Best regards,
Hi @GodisGood,
Thanks for your interesting question. Someone with knowledge on the subject will respond to you soon. Thanks, Bansah1
Hi @GodisGood,
The PrEP protocol you are considering will do a great deal to protect you from HBV, as will your antibody level. As you cleared the acute HBV infection, then you either have no HBV in your liver, or if you do, it would be a vanishingly low level and would be under excellent control by the immune system (that’s common after clearance of acute infections). Therefore, the risk of HBV resurgence upon stopping PrEP would be very low, particularly if you are not immunosuppressed for some reason.
In short, the biology of HBV infections supports your physician’s recommendation. If s/he feels PrEP would be a good option for you given your health status and life style, then I would not let a very small (and possibly theoretical) possibility of HBV resurgence stop you from gaining the protection that PrEP provides.
I wish you the very best,
John.
Goo afternoon
I also have a question regarding PrEP, but for someone with chronic HepB infection. I was talking with my provider and since I’m on Vemlidy as part of my HepB treatment, they mentioned that I can get prep but, or they will have to adjust the dosage when Including the new medicine or switch me completely.
Now only FDA approved medication as PrEP are not the one used as FDA approved medication for HepB, my question is will I be able to stay on Vemlidy and get PrEP with different dosage since they both have tenofovir? Or I will need to switch to just one that will cover both.
Also I know that Apretude have different active ingredient that any of others medicine , is that combination with Vemlidy smart?
Thank you
I cannot reply in detail because I am not a physician, but it is important not to take too much tenofovir because it can cause kidney problems in high doses. That’s probably why your caregiver is discussing changing medications and/or doses.
John.