Genital Immune Cell Activation and Tenofovir Gel Efficacy: A Case-Control Study.

Genital inflammation (GI) undermines topical human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) efficacy through unknown mechanisms. Here, associations between activated endocervical CD4 + T-cell numbers and higher deoxyadenosine triphosphate (dATP) concentrations suggest that competition for intracellular metabolites within HIV target cells may reduce the efficacy of antiretroviral-based PrEP in women with GI.
Competing Interests: Potential conflicts of interest. W. H. and J. G. G.-L. report royalties or licenses from Mylan, Laurus Generics, TAD Pharma, and CIPLA Limited. J. G. G.-L. and W. H. are named in the US govern­ment patents on Inhibition of HIV infection through chemoprophylaxis (US patents 9044509B2, 9579333, 9937191, 10335423B2), HIV Post-exposure prophylaxis (US patent 11,191,763 B2), and HIV pre-exposure prophylaxis (US govt patent application 17/628,170). All other authors re­port no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors con­sider relevant to the content of the manuscript have been disclosed.
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