在波兰弗罗茨拉夫使用暴露前预防 (PrEP) 期间发生的艾滋病毒感染事件 (2017-2023年):现实生活经验
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Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
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Bartosz Szetela1,2, Karol Serwin3, Mateusz Bozejko4
1Infectious Diseases, Liver Disease and Acquired Immune Deficiencies, Wroclaw Medical University, Wroclaw, Poland bartoszetela@gmail.com.
Sexually transmitted infections
|February 27, 2025
概括
使用emtricitabine/tenofovir disoproxil (FTC/TDF) 的暴露前预防 (PrEP) 在与男性发生性关系 (MSM) 的波兰男性中显示出高效率. 失败与对按需剂量计划的不最佳遵守有关.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 预防艾滋病毒/艾滋病 预防
背景情况:
- 暴露前预防 (PrEP) 是一种关键的艾滋病毒预防策略.
- 在中欧和东欧,关于PrEP疗效的现实数据有限.
- 对于有效的PrEP疗法,坚持是至关重要的.
研究的目的:
- 评估在波兰使用PrEP的与男性发生性关系的男性 (MSM) 之间的艾滋病毒发病率.
- 为了确定与PrEP队列中的HIV血清转化相关的因素.
- 在现实环境中评估通用emtricitabine/tenofovir disoproxil (FTC/TDF) 的有效性.
主要方法:
- 使用通用FTC/TDF的887名MSM的观察队列研究.
- 随访持续时间为2587人年 (PY).
- 通过分子和免疫试验证实艾滋病毒感染;对HIV-1A6序列的基因分析.
主要成果:
- 观察到9例 (1%) 发生的艾滋病毒感染,每100个PY发生率为0.347 (90.9%的相对风险降低).
- 所有感染都发生在使用按需FTC/TDF的MSM中,主要是由于错过剂量.
- 获得了B和A6亚型,没有传染药物耐药性的证据;四个A6感染显示独立的血统引入.
结论:
- 一般的FTC/TDF PrEP在坚持最佳时,对MSM的HIV预防非常有效.
- 低于最佳的按需剂量遵守是PrEP失败的重要原因之一.
- 为了最大限度地提高有效性,对按需PrEP剂量进行清晰的沟通和教育至关重要.
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