Chapter 15 - Evaluating the effectiveness of recommended HIV adult postexposure prophylaxis drug regimens by using fuzzy PROMETHEE

Abstract

This chapter evaluates the effectiveness of 22 different selected adult postexposure prophylaxis (PEP) antiretroviral therapy (ART) regimens by using fuzzy PROMETHEE, which is a multicriteria decision-making method. PEP ART regimens are used to prevent the acquisition of HIV infection after potential exposure. Although guidelines are present, selecting a patient-specific effective PEP ART regimen is still complicated. Thus, the effectiveness of frequently administered adult PEP ART regimens was analyzed by Fuzzy PROMETHEE. This method allows the mutual comparison between alternatives and evaluates the best outcome using the criteria and their associated weights (represented by fuzzy-numbers). The criteria associated with each alternative regimen were side effects, practicability, size of tablet, number of tablets, drug-drug interaction, pregnancy, genetic barrier, glomerular filtration rate of the kidneys and being a member of a key population. These criteria linked with their weights were used to define the most effective regimen (determined by clinical infectious disease experts). According to our evaluation, the results indicated that integrase class-based dolutegravir + tenofovir/disoproxil fumarate/emtricitabine (DTG + TDF/FTC) was the most effective regimen. Therefore, the fuzzy PROMETHEE method was able to evaluate the potency of the selected adult PEP ART regimens in a rapid and reliable manner.