BACKGROUND Potential bidirectional drug-drug interactions between feminizing hormone therapy (FHT) and antiretroviral therapy (ART) are of concern for trans women with HIV and their healthcare providers. This study aimed to characterize patterns of FHT and ART among trans women with HIV and to compare serum hormone levels to trans women without HIV. METHODS Charts of trans women were reviewed at seven HIV primary care or endocrinology clinics in Toronto and Montreal from 2018 to 2019. ART regimens, FHT use, serum estradiol, and serum testosterone levels were compared on the basis of HIV status (positive, negative, missing/unknown). RESULTS Of 1495 trans women, there were 86 trans women with HIV, of whom 79 (91.8%) were on ART. ART regimens were most commonly integrase inhibitor-based (67.4%), many boosted with ritonavir or cobicistat (45.3%). Fewer (71.8%) trans women with HIV were prescribed FHT, compared to those without HIV (88.4%) and those with missing/unknown status (90.2%, p < 0.001). Among trans women on FHT with recorded serum estradiol (n = 1153), there was no statistical difference in serum estradiol between those with HIV (median: 203 pmol/L, IQR: 95.5, 417.5) and those with negative (200 mol/L [113, 407]) or missing/unknown HIV status (227 pmol/L [127.5, 384.5) (p = 0.633). Serum testosterone concentrations were also similar between groups. CONCLUSIONS In this cohort, trans women with HIV were prescribed FHT less often than trans women with negative or unknown HIV status. There was no difference in serum estradiol or testosterone levels of trans women on FHT regardless of HIV status, providing reassurance regarding potential drug-drug interactions between FHT and ART.

中文翻译：

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对加拿大一组感染和未感染艾滋病毒的跨性别女性进行女性化激素治疗。

背景技术女性化激素疗法（FHT）和抗逆转录病毒疗法（ART）之间潜在的双向药物相互作用引起了感染艾滋病毒的跨性别女性及其医疗保健提供者的关注。本研究旨在描述感染 HIV 的跨性别女性的 FHT 和 ART 模式，并比较未感染 HIV 的跨性别女性的血清激素水平。方法 对 2018 年至 2019 年多伦多和蒙特利尔的七个 HIV 初级保健或内分泌诊所的跨性别女性图表进行了审查。根据 HIV 状态（阳性、阴性、失踪/未知）。结果 在 1495 名跨性别女性中，有 86 名跨性别女性感染了艾滋病毒，其中 79 人（91.8%）正在接受抗逆转录病毒治疗。ART 治疗方案最常见的是基于整合酶抑制剂 (67.4%)，许多治疗方案还使用利托那韦或考比司他 (cobicistat) (45.3%)。与未感染 HIV 的跨性别女性 (88.4%) 和身份缺失/未知的跨性别女性 (90.2%，p < 0.001) 相比，感染 HIV 的跨性别女性接受 FHT 治疗的比例较低 (71.8%)。在记录有血清雌二醇的接受 FHT 的跨性别女性中 (n = 1153)，HIV 感染者（中位数：203 pmol/L，IQR：95.5、417.5）和 HIV 阴性者（200 mol/L）之间的血清雌二醇没有统计学差异[113, 407]）或缺失/未知的 HIV 状态（227 pmol/L [127.5, 384.5）（p = 0.633）。各组之间的血清睾酮浓度也相似。结论 在该队列中，感染 HIV 的跨性别女性接受 FHT 治疗的频率低于 HIV 阴性或未知的跨性别女性。无论 HIV 状况如何，接受 FHT 的跨性别女性的血清雌二醇或睾酮水平没有差异，这为 FHT 和 ART 之间潜在的药物相互作用提供了保证。