Feminizing hormone therapy in a Canadian cohort of transgender women with and without HIV.

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Ian Armstrong, Ashley Lacombe-Duncan, Mostafa Shokoohi, Yasmeen Persad, Alice Tseng, Raymond Fung, Angela Underhill, Pierre Côté, Nimâ Machouf, Adrien Saucier, Brenda Varriano, Monica Brundage, Reilly Jones, Thea Weisdorf, John Goodhew, John MacLeod, Mona Loutfy
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Abstract

Background: Potential bidirectional drug-drug interactions between feminizing hormone therapy (FHT) and antiretroviral therapy (ART) are of concern for trans women with HIV and their healthcare providers. This study aimed to characterize patterns of FHT and ART among trans women with HIV and to compare serum hormone levels to trans women without HIV.

Methods: Charts of trans women were reviewed at seven HIV primary care or endocrinology clinics in Toronto and Montreal from 2018 to 2019. ART regimens, FHT use, serum estradiol, and serum testosterone levels were compared on the basis of HIV status (positive, negative, missing/unknown).

Results: Of 1495 trans women, there were 86 trans women with HIV, of whom 79 (91.8%) were on ART. ART regimens were most commonly integrase inhibitor-based (67.4%), many boosted with ritonavir or cobicistat (45.3%). Fewer (71.8%) trans women with HIV were prescribed FHT, compared to those without HIV (88.4%) and those with missing/unknown status (90.2%, p < 0.001). Among trans women on FHT with recorded serum estradiol (n = 1153), there was no statistical difference in serum estradiol between those with HIV (median: 203 pmol/L, IQR: 95.5, 417.5) and those with negative (200 mol/L [113, 407]) or missing/unknown HIV status (227 pmol/L [127.5, 384.5) (p = 0.633). Serum testosterone concentrations were also similar between groups.

Conclusions: In this cohort, trans women with HIV were prescribed FHT less often than trans women with negative or unknown HIV status. There was no difference in serum estradiol or testosterone levels of trans women on FHT regardless of HIV status, providing reassurance regarding potential drug-drug interactions between FHT and ART.

女性化激素治疗在加拿大跨性别妇女的队列感染和不感染艾滋病毒。
背景:女性化激素治疗(FHT)和抗逆转录病毒治疗(ART)之间潜在的双向药物-药物相互作用是感染艾滋病毒的跨性别女性及其医疗保健提供者关注的问题。本研究旨在描述感染艾滋病毒的跨性别女性的FHT和ART模式,并将血清激素水平与未感染艾滋病毒的跨性别女性进行比较。方法:回顾2018年至2019年多伦多和蒙特利尔7家艾滋病初级保健或内分泌科诊所的跨性别女性图表。ART方案、FHT使用、血清雌二醇和血清睾酮水平根据HIV状态(阳性、阴性、缺失/未知)进行比较。结果:1495名跨性别女性中,有86名跨性别女性感染艾滋病毒,其中79人(91.8%)接受抗逆转录病毒治疗。抗逆转录病毒治疗方案最常见的是整合酶抑制剂为主(67.4%),许多方案增加了利托那韦或可比司他(45.3%)。与未感染艾滋病毒者(88.4%)和缺失/未知状态者(90.2%,p 0.001)相比,感染艾滋病毒的跨性别女性(71.8%)得到FHT处方。经FHT检测有血清雌二醇记录的跨性别女性(n = 1153)中,HIV感染者(中位数:203 pmol/L, IQR: 95.5, 417.5)与HIV阴性(200 mol/L[113, 407])或HIV缺失/未知(227 pmol/L[127.5, 384.5)之间的血清雌二醇水平无统计学差异(p = 0.633)。两组间血清睾酮浓度也相似。结论:在这个队列中,感染HIV的跨性别女性比感染HIV阴性或未知的跨性别女性更少使用FHT。不论HIV感染状况如何,接受FHT治疗的跨性别女性血清雌二醇或睾酮水平没有差异,这为FHT和ART之间潜在的药物-药物相互作用提供了保证。
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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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