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RESEARCH ARTICLE

Acute facial neuralgia related to initiation of emtricitabine/tenofovir for HIV PrEP: a report of two cases in a PrEP demonstration trial

Zhuoheng Yin https://orcid.org/0009-0006-7012-5986 A B # , Rayner Kay Jin Tan B # , Joseph D. Tucker https://orcid.org/0000-0003-2804-1181 B C , Quanmin Li D , Renslow Sherer E , Linghua Li D and Weiming Tang https://orcid.org/0000-0002-9026-707X A B *
+ Author Affiliations
- Author Affiliations

A Dermatology Hospital Southern Medical University, Guangzhou, China.

B University of North Carolina Project-China, Guangzhou, China.

C Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

D Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China.

E Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA.

* Correspondence to: weiming_tang@med.unc.edu
# These authors contributed equally to this paper

Handling Editor: Jason Ong

Sexual Health 21, SH23129 https://doi.org/10.1071/SH23129
Submitted: 24 July 2023  Accepted: 9 January 2024  Published: 29 January 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing

Abstract

Background

Emtricitabine (FTC) and tenofovir disoproxil fumarate (TDF) fixed-dose combination (FTC/TDF) is generally well-tolerated, although treatment-related adverse events have been reported.

Methods

We report two cases of persons using FTC/TDF PrEP who had acute neuralgia in a Chinese PrEP demonstration trial.

Results

Neurological symptoms subsided upon treatment discontinuation. Symptoms were reported as similar to one case’s previous experiences with dolutegravir (DTG) + FTC + tenofovir alafenamide (TAF) (for PEP), leading to permanent discontinuation of PrEP.

Conclusion

Acute facial neuralgia appears to be a rare idiosyncratic adverse event to FTC/TDF.

Keywords: adverse effect, discontinuation, facial disturbance, FTC/TDF, MSM, neuralgia, pre-exposure prophylaxis, PrEP.

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