Update on Managing the Risks of Exposure to Lentiviral and Retroviral Vectors.

Gary R Fujimoto Dawn P Wooley Karen B Byers Otto O Yang Amy J Behrman Thomas H Winters T Warner Hudson

J Occup Environ Med

From the Occupational and Internal Medicine Consultant, Los Altos, California (G.R.F.); Department of Neuroscience, Cell Biology, and Physiology, Wright State University, Dayton, Ohio (D.P.W.); Dana-Farber Cancer Institute, Boston, Massachusetts (K.B.B.); Division of Infectious Diseases, Department of Medicine, and Department of Microbiology, Immunology, and Molecular Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California (O.O.Y.); Division of Occupational Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (A.J.B.); Occupational Health Programs at the Boston Children's Hospital and Dana Farber Cancer Institute, Research Occupational Health Program and the National Emerging Infectious Disease Laboratories, Boston University, and the Harvard T.H. Chan School of Public Health, Boston, Massachusetts (T.H.W.); and Department of Occupational and Environmental Health, University of California Irvine, Irvine, California (T.W.H.).

Published: October 2024

Objective: This paper aims to review the risks associated with using lentiviral and retroviral vectors in research and clinical settings and to propose an update to an effective treatment plan.

Methods: Risks of exposure were evaluated based on vector design, safety features, viral tropism, transgene, and means and modes of transmission. These risks were weighed against the potential risks and benefits of current HIV medications.

Results: We recommend the following postexposure prophylactic treatment for significant lentiviral vector exposures: 1) dolutegravir 50 mg taken once a day for 7 days and 2) tenofovir disoproxil fumarate 300 mg taken once a day for 7 days (28 days of both medications for replication-competent vectors).

Conclusions: Because of the highly efficient delivery of transgenes by modern lentiviral and retroviral vectors, postexposure prophylaxis is indicated to prevent vector integration and oncogenic risks.

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http://dx.doi.org/10.1097/JOM.0000000000003166	DOI Listing

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