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Current HIV/AIDS Reports
Erschienen in: Current HIV/AIDS Reports 2/2013

01.06.2013 | The Global Epidemic (Q Abdool Karim, Section Editor)

Use of Antiretrovirals for HIV Prevention: What Do We Know and What Don’t We Know?

verfasst von: Jared M. Baeten, Robert Grant

Erschienen in: Current HIV/AIDS Reports | Ausgabe 2/2013

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Abstract

Pre-exposure prophylaxis (PrEP), in which HIV uninfected persons with ongoing HIV risk use antiretroviral medications as chemoprophylaxis against sexual HIV acquisition, is a promising new HIV prevention strategy. Proof-of-concept that PrEP, as oral or vaginal topical tenofovir-based products, protects against sexual HIV acquisition has been demonstrated in clinical trials conducted among men who have sex with men and heterosexual men and women. The degree of HIV protection in these trials was strongly related to the level of adherence to PrEP. Many questions are yet unanswered – including how to motivate uptake of and sustain adherence to PrEP for HIV prevention, how much PrEP use is enough to achieve HIV protection, and the potential of “next-generation” PrEP agents to improve on this effective technology.
Literatur
1.
Cohen MS, Gay C, Kashuba AD, Blower S, Paxton L. Narrative review: antiretroviral therapy to prevent the sexual transmission of HIV-1. Ann Intern Med. 2007;146:591–601.PubMedCrossRef
2.
Baeten J, Celum C. Systemic and topical drugs for the prevention of HIV infection: antiretroviral pre-exposure prophylaxis. Annu Rev Med. 2012;27:27.
3.
•• Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505. This randomized clinical trial provided definitive evidence that use of antiretroviral treatment by HIV-infected persons reduces the risk of HIV transmission to sexual partner. Use of antiretroviral medications for treatment of HIV infected persons to reduce infectiousness and PrEP for HIV uninfected persons to reduce susceptibility are complementary prevention strategies.PubMedCrossRef
4.
Donnell D, Baeten JM, Kiarie J, Thomas KK, Stevens W, et al. Heterosexual HIV-1 transmission after initiation of antiretroviral therapy: a prospective cohort analysis. Lancet. 2010;375:2092–8.PubMedCrossRef
5.
•• Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. N Engl J Med. 2012;367:399–410. This randomized clinical trial demonstrated that oral PrEP using daily oral FTC/TDF and daily oral TDF alon, was efficacious for prevention of HIV acquisition in both heterosexual men and women who were in HIV serodiscordant partnerships.PubMedCrossRef
6.
•• Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363:2587–99. This randomized clincal trial demonstrated that oral PrEP, using daily oral FTC/TDF, was efficacious for prevention of HIV acquisition in men who have sex with men.PubMedCrossRef
7.
•• Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012;367:423–34. This randomized clinical trial provides additional evidence of the efficacy FTC/TDF PrEP for HIV prevention among heterosexuals.PubMedCrossRef
8.
9.
UNAIDS/WHO. AIDS Epidemic Update 2009.
10.
Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, et al. Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19:1525–34.PubMedCrossRef
11.
Dunkle KL, Stephenson R, Karita E, Chomba E, Kayitenkore K, et al. New heterosexually transmitted HIV infections in married or cohabitating couples in urban Zambia and Rwanda: an analysis of survey and clinical data. Lancet. 2008;371:2183–91.PubMedCrossRef
12.
Curran K, Baeten JM, Coates TJ, Kurth A, Mugo NR, Celum C. HIV-1 prevention for HIV-1 serodiscordant couples. Current HIV/AIDS Reports. 2012;9:160–70.PubMedCrossRef
13.
Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000–2006: a systematic review. PLoS Med. 2007;4:e339.PubMedCrossRef
14.
Kumwenda NI, Hoover DR, Mofenson LM, Thigpen MC, Kafulafula G, et al. Extended antiretroviral prophylaxis to reduce breast-milk HIV-1 transmission. N Engl J Med. 2008;359:119–29.PubMedCrossRef
15.
Mofenson LM. Protecting the next generation–eliminating perinatal HIV-1 infection. N Engl J Med. 2010;362:2316–8.PubMedCrossRef
16.
Connor EM, Sperling RS, Gelber R, Kiselev P, Scott G, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. Pediatric AIDS Clinical Trials Group Protocol 076 Study Group. N Engl J Med. 1994;331:1173–80.PubMedCrossRef
17.
Guay LA, Musoke P, Fleming T, Bagenda D, Allen M, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: HIVNET 012 randomised trial. Lancet. 1999;354:795–802.PubMed
18.
Garcia-Lerma JG, Otten RA, Qari SH, Jackson E, Cong ME, et al. Prevention of rectal SHIV transmission in macaques by daily or intermittent prophylaxis with emtricitabine and tenofovir. PLoS Med. 2008;5:e28.PubMedCrossRef
19.
Tsai CC, Follis KE, Sabo A, Beck TW, Grant RF, et al. Prevention of SIV infection in macaques by (R)-9-(2-phosphonylmethoxypropyl)adenine. Science. 1995;270:1197–9.PubMedCrossRef
20.
Garcia-Lerma JG, Cong ME, Mitchell J, Youngpairoj AS, Zheng Q, et al. Intermittent prophylaxis with oral truvada protects macaques from rectal SHIV infection. Sci Transl Med. 2010;2:14ra4.PubMedCrossRef
21.
Parikh UM, Dobard C, Sharma S, Cong ME, Jia H, et al. Complete protection from repeated vaginal simian-human immunodeficiency virus exposures in macaques by a topical gel containing tenofovir alone or with emtricitabine. J Virol. 2009;83:10358–65.PubMedCrossRef
22.
Subbarao S, Otten RA, Ramos A, Kim C, Jackson E, et al. Chemoprophylaxis with tenofovir disoproxil fumarate provided partial protection against infection with simian human immunodeficiency virus in macaques given multiple virus challenges. J Infect Dis. 2006;194:904–11.PubMedCrossRef
23.
• Hendrix CW. The clinical pharmacology of antiretrovirals for HIV prevention. Curr Opin HIV AIDS. 2012;7:498–504. This recent article comprehensively reviews the clinical pharmacology of PrEP for HIV prevention.PubMedCrossRef
24.
Kashuba AD, Patterson KB, Dumond JB, Cohen MS. Pre-exposure prophylaxis for HIV prevention: how to predict success. Lancet. 2011;6:6.
25.
Patterson KB, Prince HA, Kraft E, Jenkins AJ, Shaheen NJ, et al. Penetration of tenofovir and emtricitabine in mucosal tissues: implications for prevention of HIV-1 transmission. Sci Transl Med. 2011;3:112re4.PubMedCrossRef
26.
• Abdool Karim SS, Kashuba AD, Werner L, Abdool Karim QA. Drug concentrations after topical and oral antiretroviral pre-exposure prophylaxis: implications for HIV prevention in women. Lancet. 2011;378:279–81. This report details the relationship between tenofovir exposure and HIV protection in the CAPRISA 004 study.CrossRef
27.
•• Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329:1168–74. This randomized clinical trial demonstrated that 1 % tenofovir vaginal gel, when used with coitus, reduced HIV risk in South African women.PubMedCrossRef
28.
Stein ZA. HIV prevention: the need for methods women can use. Am J Public Health. 1990;80:460–2.PubMedCrossRef
29.
Mujugira A, Baeten JM, Donnell D, Ndase P, Mugo NR, et al. Characteristics of HIV-1 serodiscordant couples enrolled in a clinical trial of antiretroviral pre-exposure prophylaxis for HIV-1 prevention. PLoS One. 2011;6:e25828.PubMedCrossRef
30.
• Karim SS, Karim QA. Antiretroviral prophylaxis: a defining moment in HIV control. Lancet. 2011;378:e23–5. This commentary succinctly presents the importance of PrEP trials for HIV prevention.PubMedCrossRef
31.
• van der Straten A, Van Damme L, Haberer JE, Bangsberg DR. Unraveling the divergent results of pre-exposure prophylaxis trials for HIV prevention. AIDS. 2012;26:F13–9. This review article summarizes possible hypotheses for divergent PrEP trial results.PubMedCrossRef
32.
•• Van Damme L, Corneli A, Ahmed K, Agot K, Lombaard J, et al. Preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2012;367:411–22. This randomized clinical trial among women from Kenya, South Africa, and Tanzania failed to demonstration HIV protection using emtricitabine/tenofovir oral PrEP, likely as a result of low PrEP use.PubMedCrossRef
33.
34.
35.
Martin M, Vanichseni S, Suntharasamai P, Sangkum U, Chuachoowong R, et al. Enrollment characteristics and risk behaviors of injection drug users participating in the Bangkok Tenofovir Study, Thailand. PLoS One. 2011;6:e25127.PubMedCrossRef
36.
37.
• Anderson PL, Glidden DV, Liu A, Buchbinder S, Lama JR, et al. Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012;4:151ra25. This recent article details the relationship between PrEP blood concentrations and HIV protection in the iPrEx study.CrossRef
38.
Bangsberg D, Haberer J, Psaros C, Baeten J, Katabira E, et al. High adherence and high effectiveness observed in HIV discordant couples: Partners PrEP Study, adherence monitoring and counseling substudy. Proc. 19th Conference on Retroviruses and Opportunistic Infections (CROI), Seattle, WA, 2012:Abstract 1067.
39.
Donnell D, Baeten J, Hendrix C, Bumpus N, Bangsberg D, et al. Tenofovir disoproxil fumarate drug levels indicate PrEP use is strongly correlated with HIV-1 protective effects: Kenya and Uganda. Proc. 19th Conference on Retroviruses and Opportunistic Infections (CROI), Seattle, WA, 2012:Abstract 30.
40.
Liu A, Vittinghoff E, Irby R, Mulligan K, Sellmeyer D, et al. BMD loss in HIV– men participating in a TDF PrEP clinical trial in San Francisco. Proc. 18th Conference on Retroviruses and Opportunistic Infections (CROI), Boston, MA, 2011:Abstract 93.
41.
Mugo N, Celum C, Donnell D, Campbell J, Bukusi E, et al. Pregnancy incidence and birth outcomes in a clinical trial of PrEP: Uganda and Kenya. Proc. 19th Conference on Retroviruses and Opportunistic Infections, Seattle, USA, 5–8 March 2012:Abstract 1060.
42.
43.
Anderson P, Meditz A, Zheng J-H, Predhomme J, Klein B, et al. Cellular pharmacology of tenofovir and emtricitabine in blood, rectal, and cervical cells from HIV– volunteers. Proc. 19th Conference on Retroviruses and Opportunistic Infections (CROI), Seattle, WA, 2012:Abstract 587.
44.
• Amico KR. Adherence to preexposure chemoprophylaxis: the behavioral bridge from efficacy to effectiveness. Curr Opin HIV AIDS. 2012;7:542–8. This review article addresses key challenges in adherence to PrEP.PubMedCrossRef
45.
Matthews LT, Baeten JM, Celum C, Bangsberg DR. Periconception pre-exposure prophylaxis to prevent HIV transmission: benefits, risks, and challenges to implementation. AIDS. 2010;24:1975–82.PubMedCrossRef
46.
Mutua G, Sanders E, Mugo P, Anzala O, Haberer JE, et al. Safety and adherence to intermittent pre-exposure prophylaxis (PrEP) for HIV-1 in African men who have sex with men and female sex workers. PLoS One. 2012;7:e33103.PubMedCrossRef
47.
48.
49.
• World Health Organization. Guidance on pre-exposure oral prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV: recommendation for use in the context of demonstration projects, World Health Organization, Geneva. 2012. WHO guidance on next steps for implementing PrEP for HIV prevention.
50.
• Interim guidance for clinicians considering the use of preexposure prophylaxis for the prevention of HIV infection in heterosexually active adults. MMWR. 2012;61:586–9. US CDC guidance on prescribing PrEP for HIV prevention in heterosexuals.
51.
• Interim guidance: preexposure prophylaxis for the prevention of HIV infection in men who have sex with men. MMWR. 2011;60:65–8. US CDC guidance on prescribing PrEP for HIV prevention in men who have sex with men.
52.
Hallett TB, Baeten JM, Heffron R, Barnabas R, de Bruyn G, et al. Optimal uses of antiretrovirals for prevention in HIV-1 serodiscordant heterosexual couples in South Africa: a modelling study. PLoS Med. 2011;8:e1001123.PubMedCrossRef
53.
Juusola JL, Brandeau ML, Owens DK, Bendavid E. The cost-effectiveness of preexposure prophylaxis for HIV prevention in the United States in men who have sex with men. Ann Intern Med. 2012;156:541–50.PubMedCrossRef
54.
Walensky RP, Park JE, Wood R, Freedberg KA, Scott CA, et al. The cost-effectiveness of pre-exposure prophylaxis for HIV infection in South African women. Clin Infect Dis. 2012;54:1504–13.PubMedCrossRef
55.
Karim SS, Kashuba AD, Werner L, Karim QA. Drug concentrations after topical and oral antiretroviral pre-exposure prophylaxis: implications for HIV prevention in women. Lancet. 2011;378:279–81.PubMedCrossRef
56.
Metadaten
Titel
Use of Antiretrovirals for HIV Prevention: What Do We Know and What Don’t We Know?
verfasst von
Jared M. Baeten
Robert Grant
Publikationsdatum
01.06.2013
Verlag
Current Science Inc.
Erschienen in
Current HIV/AIDS Reports / Ausgabe 2/2013
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-013-0157-9

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