Treatment regimens for HIV or Hepatitis C Virus do not need to be altered during Paxlovid administration for COVID-19

Treatment with Paxlovid (nirmatrelvir/ritonavir 300/100 mg two times per day for 5 days) is expected to play an important role in patients with mild-to-moderate COVID-19 who are at risk of disease progression. Nirmatrelvir targets the SARS-CoV-2 3CL protease, whereas ritonavir acts as a pharmacological enhancer. Paxlovid is an inhibitor of CYP3A (Cytochrome P450, family 3, subfamily A) and may increase plasma concentrations of drugs that are primarily metabolised by CYP3A. Guidance has been released to indicate that people with HIV or hepatitis C virus who take Paxlovid can continue their antiviral treatment, including regimens containing ritonavir or cobicistat, without interruption or dose adjustments. With concomitant use, patients should be monitored for a potentially increased risk of adverse events. Other important interactions exist, including reduced Paxlovid therapeutic effect by drugs that induce CYP3A, that require careful management.1

Infectious Diseases Society of America and HIV Medicine Association. Paxlovid for the treatment of COVID-19: considerations for people with HIV and hepatitis C. December 31, 2021. https://www.idsociety.org/globalassets/covid-19-real-time-learning-network/patient-populations/hiv/oral-covid-tx-considerations-for-people-with-hiv-and-hcv.pdf.

Published in Sexually Transmitted Infections: Depression is more common in MSM who report either sexual inactivity or condomless sex than in men who report condom-protected sex only

Studies on the association between depression and condomless sex have reported discordant findings. One possible explanation is that participants who report no recent sexual intercourse are merged with those who report condom-protected sex into a single ‘no condomless sex’ comparator group. Using data from two cross-sectional cohorts …