{"doi":"10.1093/jac/dkaa016","title":"Plasma and intracellular pharmacokinetics of tenofovir disoproxil fumarate and emtricitabine in transgender women receiving feminizing hormone therapy","abstract":"BACKGROUND: Transwomen have an increased risk of HIV acquisition compared with other adults. Drug-drug interactions between pre-exposure prophylaxis (PrEP) and gender-affirming therapy are cited as a reason for poor PrEP uptake among transwomen. We evaluated plasma tenofovir and emtricitabine pharmacokinetics and their active intracellular anabolites, tenofovir-diphosphate and emtricitabine-triphosphate, in transwomen receiving feminizing hormones. METHODS: We enrolled HIV-negative transwomen (≥19 years) not receiving PrEP. Participants took oral tenofovir disoproxil fumarate/emtricitabine 300/200 mg daily for 14 days. Plasma was collected at 0 h (pre-dose), 0.5, 1, 2, 3, 4, 6, 8 and 12 h on day 14 post-tenofovir disoproxil fumarate/emtricitabine dose. The plasma AUC0-24 was calculated using the trapezoidal rule and compared with historical HIV-negative cisgender adults as geometric mean ratios (GMRs, 90% CI). Secondarily, tenofovir-diphosphate and emtricitabine-triphosphate from PBMCs collected at 0 h and 12 h were reported descriptively as geometric means (90% CI). Clinical trials registration: NCT03270969. RESULTS: Among 15 transwomen (mean age 32 years), geometric mean tenofovir and emtricitabine plasma AUC0-24 were lower compared with controls: tenofovir, 2.10 versus 2.76 mg·h/L, GMR 0.76 (0.65-0.90), P = 0.01; emtricitabine, 9.15 versus 10.64 mg·h/L, GMR 0.86 (0.75-0.98), P = 0.07. Tenofovir-diphosphate and emtricitabine-triphosphate concentrations were higher than previously reported in the literature: 167.1 (146.6-190.5) fmol/106 cells and 15.4 (13.8-17.3) pmol/106 cells, respectively. CONCLUSIONS: We observed lower plasma tenofovir and emtricitabine concentrations in transwomen compared with historical cisgender adults, yet intracellular tenofovir-diphosphate and emtricitabine-triphosphate concentrations were higher than previously reported in PBMCs. Understanding the differences of PrEP pharmacokinetics in plasma and tissue compartments and the resultant impact on efficacy remains important for transwomen.","journal":"Journal of Antimicrobial Chemotherapy","year":2020,"id":101340,"datarank":1.6761456103333763,"base_score":3.332204510175204,"endowment":3.332204510175204,"self_citation_contribution":0.49983067652628066,"citation_network_contribution":1.1763149338070957,"self_endowment_contribution":0.49983067652628066,"citer_contribution":1.1763149338070957,"corpus_percentile":null,"corpus_rank":null,"citation_count":27,"citer_count":23,"citers_with_citation_signal":19,"citers_with_endowment":19,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.953,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03270969"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":259564,"name":"Anthony T. Podany","orcid":"0000-0002-8371-0379","position":1,"is_corresponding":false},{"id":496121,"name":"Joshua P Havens","orcid":"0000-0001-9894-615X","position":2,"is_corresponding":false},{"id":247281,"name":"Sara H Bares","orcid":"0000-0002-2130-2505","position":3,"is_corresponding":false},{"id":426795,"name":"Shetty Ravi Dyavar","orcid":"0000-0002-2141-7214","position":4,"is_corresponding":false},{"id":496122,"name":"Yeongjin Gwon","orcid":"0000-0001-6974-337X","position":5,"is_corresponding":false},{"id":496123,"name":"Tanner M Johnson","orcid":"0000-0002-9181-8347","position":6,"is_corresponding":false},{"id":496814,"name":"N. Jean Amoura","orcid":null,"position":7,"is_corresponding":false},{"id":259563,"name":"Courtney V. Fletcher","orcid":"0000-0002-3703-7849","position":8,"is_corresponding":false},{"id":345925,"name":"Kimberly K. Scarsi","orcid":"0000-0001-9406-693X","position":9,"is_corresponding":false},{"id":496120,"name":"Lauren R. Cirrincione","orcid":"0000-0002-9115-1060","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-18T22:39:38.259162Z","pmid":"32065631","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}