Post-exposure prophylaxis with favipiravir among household close contacts to confirmed COVID-19 cases: A cluster-randomized trial (PEPfavi)

IF 4.8 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2026-04-01 Epub Date: 2026-01-14 DOI:10.1016/j.jiph.2026.103150

Taweegrit Siripongboonsitti , Teerapat Ungtrakul , Kriangkrai Tawinprai , Krongkwan Niemsorn , Kunsuda Punjachaipornpol , Worrawat Sangwipasnapaporn , Natcha Wattanapokasilp , Marisa Muadchimkaew , Saowanee Wongpatcharawarakul , Kamonwan Soonklang , Nithi Mahanonda

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引用次数: 0

Abstract

Background

Household transmission of SARS-CoV-2 remains a key driver of community spread, with secondary attack rates in Thai households reaching approximately 50 %. There is limited evidence supporting the efficacy of antiviral post-exposure prophylaxis (PEP) in this context.

Methods

The phase 2/3, open-label, (1:1) cluster-randomized controlled trial in Thailand, 168 household close contacts from 76 index cases were enrolled to receive either favipiravir-PEP (FPV-PEP) (1600–2000 mg/day for 7 days) or usual care. The efficacy of FPV-PEP was investigated in preventing SARS-CoV-2 infection after contact with index cases.

Results

The incidence of confirmed SARS-CoV-2 infection was lower in the FPV-PEP group than in the usual care group (7.32 % vs. 14.47 %), although the difference was not statistically significant. A trend toward fewer early positive rapid diagnostic test results on day 3 was observed in the FPV-PEP group. Symptom development was less frequent among FPV-PEP recipients, with fewer cases of fever, rhinorrhea, and myalgia. A significantly higher probability of remaining asymptomatic and delayed symptom onset was observed in the FPV-PEP group. No participants developed severe COVID-19 or required hospitalization.

Conclusion

FPV-PEP was associated with a lower incidence of fever, rhinorrhea, and myalgia among household contacts. While a reduction in secondary transmission was observed, it did not reach statistical significance. Further large-scale studies are warranted to clarify its role in preventing household transmission.

查看原文本刊更多论文

COVID-19确诊病例家庭密切接触者的法匹拉韦暴露后预防：一项聚类随机试验（PEPfavi）

SARS-CoV-2的家庭传播仍然是社区传播的主要驱动因素，泰国家庭的二次发病率约为50% %。在这种情况下，支持抗病毒暴露后预防（PEP）有效性的证据有限。方法在泰国进行2/3期、开放标签、（1:1）聚类随机对照试验，选取76例家庭密切接触者中的168例，分别接受favipirvir - pep (FPV-PEP) （1600 ~ 2000 mg/d，连用7 d）或常规护理。观察FPV-PEP在接触指示病例后预防SARS-CoV-2感染的效果。结果FPV-PEP组确诊SARS-CoV-2感染发生率低于常规护理组（7.32 %比14.47 %），但差异无统计学意义。在FPV-PEP组中，观察到第3天早期阳性快速诊断试验结果较少的趋势。FPV-PEP受者的症状发展较少，发热、鼻流和肌痛的病例较少。在FPV-PEP组中观察到明显更高的剩余无症状和延迟症状发作的可能性。没有参与者出现严重的COVID-19或需要住院治疗。结论fpv - pep与家庭接触者发热、流鼻、肌痛发生率较低有关。虽然观察到二次传播的减少，但没有达到统计学意义。有必要进一步进行大规模研究，以阐明其在预防家庭传播方面的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.