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BC-CFE GUIDELINES FOR THE USE OF PAXLOVID® AND ARVS

Safety considerations for nirmatrelvir/ritonavir (Paxlovid®) use in persons living with HIV whether or not on antiretroviral treatment, or persons at risk of HIV while on PrEP who are diagnosed with COVID-19 infection.

 

The COVID-19 therapy Paxlovid® consists of the antiviral medication nirmatrelvir co-packaged with the pharmacokinetic enhancer (“booster”) ritonavir, taken as a twice daily, oral, five-day treatment course, with dosage adjustment required for renal impairment (see prescribing information).

 

Nirmatrelvir/ritonavir treatment is initiated as soon as possible following a positive SARS-CoV-2 test result. Eligibility criteria for nirmatrelvir/ritonavir vary between Canadian provinces and will likely evolve over time. Also, eligibility in British Columbia may be expanded as drug supply increases. Therefore, prescribers are strongly encouraged to refer to current nirmatrelvir/ritonavir prescribing information and local guidelines for treatment eligibility and general contraindications/precautions. In British Columbia, see the BC Centre for Disease Control website: http://www.bccdc.ca/health-professionals/clinical-resources/covid-19-care/clinical-care/treatments

DOWNLOAD: BC-CFE GUIDELINES FOR THE USE OF PAXLOVID® AND ARVS

BC-CFE CDET STATEMENT ON THE USE OF COVID-19 VACCINES IN PERSONS LIVING WITH HIV

People living with HIV (PLWH) aged 5 years or older should be fully vaccinated for COVID-19, regardless of CD4 count provided that they do not have contraindications to the available age-appropriate vaccines (see below). Although the evidence was mixed in earlier studies, more recently, multiple large studies have indicated that PLWH are at increased risk of serious illness and death due to COVID-19. To date, there appears to be no significant difference in the safety profile of the authorized COVID-19 vaccines in PLWH compared to the general population.
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The British Columbia Centre for Excellence in HIV/AIDS Laboratory has discontinued gp-41 resistance testing as T-20 (enfuvirtide/Fuzeon) is no longer available in Canada as of March 31, 2025

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