Experience with the use of thixagevimab/cilgavimab for pre-exposure prophylaxis of COVID-19 in patients with HIV infection in the Omsk region

Some populations, such as those with HIV infection, may have an inadequate immune response to the coronavirus disease 2019 (COVID-19) vaccine. For these populations, administration of monoclonal antibodies may provide some additional protection. The aim of the study was to evaluate the incidence and outcomes of COVID-19 in patients with HIV infection while using the drug thixagevimab/ cilgavimab as a pre-exposure prophylaxis for a new coronavirus infection.A retrospective non-randomized study was conducted in patients with HIV infection (n = 182) who were administered thixagevimab 150 mg/cilgavimab 150 mg. The mean age of the patients was 41 years. There were 107 men and 75 women. The duration of HIV infection at the time of the study was 6.5 years. All patients were taking antiretroviral therapy. Side effects in the form of drowsiness and subfebrile fever were observed in 1.6% of patients. There was an increase in the titer of antibodies of the IgG class to SARS-CoV-2 coronavirus up to 422.12 ± 8.48 cU/ml, an increase in the average level of CD4-lymphocytes up to 407.92 ± 16.24 with a median of 450 cells/μl, a decrease in the viral load of RNA HIV up to 85.60 ± 9.50 copies/ml. No cases of novel coronavirus infection were registered among patients who received thixagevimab/cilgavimab during the study period. This study shows that thixagevimab 150 mg/cilgavimab 150 is effective in reducing the risk of SARS-CoV-2 infection and COVID-19 hospitalization in patients with HIV infection. The drug may be offered to those who cannot be vaccinated against COVID-19 to provide additional protection.

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