Preventing HIV infection: pre-exposure and postexposure prophylaxis

Area of Science:

• Infectious Diseases
• Pharmacology
• Public Health

Background:

• Growing evidence supports pre-exposure prophylaxis (PrEP) and nonoccupational postexposure prophylaxis (nPEP) for HIV prevention after sexual exposure.
• Antiretroviral (ARV) drug use in HIV prevention is increasingly recommended.
• Understanding viral reservoirs is crucial for optimizing nPEP timing.

Purpose of the Study:

• To review research supporting current recommendations for ARV use in HIV prevention.
• To discuss emerging research on viral reservoirs and its implications for nPEP timing.
• To explore factors influencing the selection of ARV agents for HIV prevention.

Main Methods:

• Literature review of studies on HIV prevention with ARVs.
• Analysis of research on antiretroviral drug distribution and transporters.
• Examination of potential impacts of race and ethnicity on ARV pharmacokinetics.

Main Results:

• Data increasingly supports PrEP and nPEP efficacy.
• Viral reservoir research suggests a need to reconsider nPEP treatment timing.
• Drug distribution, transporters, and demographic factors influence ARV choice.

Conclusions:

• PrEP and nPEP are vital components of HIV prevention strategies.
• Further research is needed to refine nPEP protocols based on viral reservoir dynamics.
• Individual patient factors, including race and ethnicity, must be considered in ARV selection for prevention.