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艾滋病毒暴露前预防:一篇综述
James Riddell1, K Rivet Amico2, Kenneth H Mayer3,4,5
1Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
JAMA
|March 28, 2018
概括
作为暴露前预防药物 (PrEP),每天使用的特诺福维尔双胺酸 (TDF) / 埃姆特里西塔宾可显著降低艾滋病毒的感染率. 这种安全有效的艾滋病毒预防策略在坚持最佳时具有很高的有效性.
科学领域:
- 传染性疾病
- 公共卫生
- 药理学
背景情况:
- 据估计,每年有4万美国人和200万全球人感染艾滋病毒.
- 综合抗逆转录病毒疗法,即特诺福维尔双酸盐 (TDF) / 埃姆特里西塔宾,是一种有效的艾滋病毒预防方法.
- 在美国,TDF/ emtricitabine用于暴露前预防的吸收率在符合条件的个人中低于20%.
研究的目的:
- 审查TDF/ emtricitabine在艾滋病毒暴露前预防 (PrEP) 的有效性和安全性.
- 突出 PrEP 减少新感染的潜力.
主要方法:
- 在2010年至2018年间发表的英语文章进行了PubMed搜索.
- 搜索词包括"预暴露"",预防"",艾滋病毒"",PrEP".
- 包括四项随机临床试验,评估每天的TDF/ emtricitabine.
主要成果:
- 在关键人群中,每日使用TDF/ emtricitabine可显著降低艾滋病毒感染率.
- 效率超过90%,与坚持使用密切相关.
- 这种疗法是安全的,耐受性很好,只有2%的人因不良反应而停止使用.
- 在PrEP期间对TDF/ emtricitabine的HIV耐药性很少见 (< 0. 1%).
结论:
- TDF/ emtricitabine是预防艾滋病毒传播的安全有效疗法.
- 对有风险的个体增加TDF/ emtricitabine的处方可以减少新的艾滋病毒感染.
- 为了最大限度地提高PrEP的效果, 确定高风险个体和提高坚持的策略至关重要.
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