长效注射PrEP在南非的估计影响:一个模型对比分析
Sarah E Stansfield1, Mia Moore1, Lise Jamieson2,3
1Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Journal of the International AIDS Society
|July 2, 2025
概括
在南非,扩大长效注射性卡博特格拉维尔 (CAB-LA) 用于艾滋病毒暴露前预防 (PrEP) 可能会显著减少新的艾滋病毒感染. 通过CAB-LA优先考虑高风险群体,对避免收购产生了重大影响.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 传染病建模 传染病建模
背景情况:
- 长效注射性卡博特格拉维尔 (CAB-LA) 在艾滋病毒暴露前预防 (PrEP) 方面表现出优于每日使用的特诺福维尔二氧化 fumarate/emtricitabine (TDF/FTC).
- 这项分析预测了在20年内在南非使用CAB-LA扩大PrEP覆盖范围的潜在影响.
研究的目的:
- 预测从2022年到2042年在南非扩大CAB-LA的PrEP覆盖范围的影响.
- 为了比较CAB-LA与TDF/FTC在各种扩散场景下避免艾滋病毒感染的有效性.
主要方法:
- 利用了三种独立校准的南非艾滋病毒传播模型:合成,EMOD-HIV和Thembisa.
- 根据多个扩展场景,预计艾滋病毒的获取和有效的PrEP覆盖范围,覆盖水平,速度和目标人群不同.
- 将PrEP扩张的情景与没有PrEP扩张的基线进行比较.
主要成果:
- 到2032年实现5%的CAB-LA覆盖率,优先考虑高暴露群体,避免了新艾滋病毒感染的中位数为43% (合成),29% (EMOD-HIV) 和10% (Thembisa).
- 与类似的TDF/FTC扩张相比,CAB-LA的扩张显示出更大的影响,分别避免了额外的19pp,18pp和3pp的HIV收购.
- 将CAB-LA覆盖率提高到15%,进一步增强了影响力,而优先考虑女性仅在模型中产生了不同的结果.
结论:
- 在南非提供CAB-LA有可能对艾滋病毒流行病产生重大影响.
- 有效的PrEP覆盖率成为不同建模场景中干预有效性的强有力的预测指标.
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