HIV感染の予防のための暴露前予防:米国予防サービスタスクフォースの勧告声明

, Douglas K Owens^1,2, Karina W Davidson³

¹Veterans Affairs Palo Alto Health Care System, Palo Alto, California.

JAMA

|June 12, 2019

まとめ

暴露前予防 (PrEP) は,高リスクの個体においてHIVのリスクを有意に低下させる. PREP の鍵となるのは,そのルールに従うことです.

科学分野:

公衆衛生
感染症
予防医療

背景:

米国では110万人以上がHIVに感染しており,2017年には38,281人が新たに診断されました.
HIV感染は治療可能なものの治療法はないし健康に重大な影響を及ぼします
米国予防サービスタスクフォース (USPSTF) は予防医療サービスに関する勧告を発行しています.

研究の目的:

HIV予防のための暴露前予防 (PrEP) に関するUSPSTFの勧告を更新する.
HIV感染リスクを減らすためのPrEP療法の有効性と安全性を評価する.

主な方法:

PrEPの利点,リスク,遵守に関する証拠の体系的なレビュー
高リスクの個人を特定するためのリスク評価ツールの診断精度の分析
プライマリケアにおける遵守率に関するPrEPの有効性の評価

主要な成果:

説得力のある証拠は PrEP が HIV の感染リスクが高い人に大きく役立つことを示しています
PrEPの有効性は,その遵守と密接に関連しており,その遵守は,その効果の実現に不可欠です.
PrEPは腎臓や消化器系の副作用など軽微な有害性があります

結論:

USPSTFは,高リスクの個人に有効な抗レトロウイルス療法と PrEP を提供することを推奨しています.
PrEPがHIV感染リスクを減少させるという実質的な効果は,高い確実性によって裏付けられています.
PrEPの有効性が HIV感染の予防に不可欠です

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