PrEP does have some rare side effects that are very important to follow through with. The first one is that in some people, PrEP can reduce the function of the kidney. For this reason it’s very, very important that when you’re starting PrEP, that you have a very careful examination of the patient’s medical history. Are they diabetic? Do they already have preexisting kidney disease? Are they on medicines that can affect renal function such as metformin or frequent doses of NSAIDs that could reduce the function of the kidney?
We also test kidney function. If you have a patient whose eGFR is less than 60, it is important to talk with a HIV specialist before initiating PrEP. We do know that occasionally, there can be a slight reduction in eGFR in our patients. We do know that when stopped the PrEP, the eGFR does tend to return back to normal. However, if you notice any concerns, worries or changes in kidney function, it’s important to have a talk with a competent, confident, PrEP prescriber or HIV specialist to discuss options and the best way to deal with these particular issues for your patients.