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The promise of pre-exposure prophylaxis with antiretroviral drugs to prevent HIV transmission: a review.
Curr Opin HIV AIDS. 2013 Jan; 8(1):50-8.CO

Abstract

PURPOSE OF REVIEW

Public health experts are wrestling with how to translate recent scientific findings from pre-exposure prophylaxis (PrEP) effectiveness trials into real-world programmes. This review summarizes clinical trial findings on oral and topical PrEP, discusses how decision-makers can evaluate the place of PrEP within combination prevention and highlights anticipated developments that could be important in future HIV-prevention strategies.

RECENT FINDINGS

PrEP taken daily as oral tablets to create systemic protection has been found to be effective in the Pre-Exposure Prophylaxis Initiative (iPrEx), Partners' PrEP and TDF2 trials, but not in Fem-PrEP or the Vaginal and Oral Interventions to Control the Epidemic (VOICE) tenofovir arm. Tenofovir gel for topical protection was effective in CAPRISA 004 when used peri-coitally but not in VOICE with daily use. These findings underscore the importance of adherence to achieve adequate drug levels and the potential additive role of PrEP within combination prevention. Pivotal phase III trials are underway of the dapivirine ring, whereas phase I trials of injectable formulations show promise.

SUMMARY

Antiretroviral-based HIV-prevention programmes should be tailored to those most likely to be adherent, providing them with state-of-the-art counselling and support to achieve high adherence during the time period of use. Long-acting products, if found well tolerated and effective, could be ideal for overcoming adherence challenges.

Authors+Show Affiliations

Department of Global Health, Academic Medical Centre, University of Amsterdam and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands. c.hankins@aighd.orgNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23201856

Citation

Hankins, Catherine A., and Mark R. Dybul. "The Promise of Pre-exposure Prophylaxis With Antiretroviral Drugs to Prevent HIV Transmission: a Review." Current Opinion in HIV and AIDS, vol. 8, no. 1, 2013, pp. 50-8.
Hankins CA, Dybul MR. The promise of pre-exposure prophylaxis with antiretroviral drugs to prevent HIV transmission: a review. Curr Opin HIV AIDS. 2013;8(1):50-8.
Hankins, C. A., & Dybul, M. R. (2013). The promise of pre-exposure prophylaxis with antiretroviral drugs to prevent HIV transmission: a review. Current Opinion in HIV and AIDS, 8(1), 50-8. https://doi.org/10.1097/COH.0b013e32835b809d
Hankins CA, Dybul MR. The Promise of Pre-exposure Prophylaxis With Antiretroviral Drugs to Prevent HIV Transmission: a Review. Curr Opin HIV AIDS. 2013;8(1):50-8. PubMed PMID: 23201856.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The promise of pre-exposure prophylaxis with antiretroviral drugs to prevent HIV transmission: a review. AU - Hankins,Catherine A, AU - Dybul,Mark R, PY - 2012/12/4/entrez PY - 2012/12/4/pubmed PY - 2013/4/30/medline SP - 50 EP - 8 JF - Current opinion in HIV and AIDS JO - Curr Opin HIV AIDS VL - 8 IS - 1 N2 - PURPOSE OF REVIEW: Public health experts are wrestling with how to translate recent scientific findings from pre-exposure prophylaxis (PrEP) effectiveness trials into real-world programmes. This review summarizes clinical trial findings on oral and topical PrEP, discusses how decision-makers can evaluate the place of PrEP within combination prevention and highlights anticipated developments that could be important in future HIV-prevention strategies. RECENT FINDINGS: PrEP taken daily as oral tablets to create systemic protection has been found to be effective in the Pre-Exposure Prophylaxis Initiative (iPrEx), Partners' PrEP and TDF2 trials, but not in Fem-PrEP or the Vaginal and Oral Interventions to Control the Epidemic (VOICE) tenofovir arm. Tenofovir gel for topical protection was effective in CAPRISA 004 when used peri-coitally but not in VOICE with daily use. These findings underscore the importance of adherence to achieve adequate drug levels and the potential additive role of PrEP within combination prevention. Pivotal phase III trials are underway of the dapivirine ring, whereas phase I trials of injectable formulations show promise. SUMMARY: Antiretroviral-based HIV-prevention programmes should be tailored to those most likely to be adherent, providing them with state-of-the-art counselling and support to achieve high adherence during the time period of use. Long-acting products, if found well tolerated and effective, could be ideal for overcoming adherence challenges. SN - 1746-6318 UR - https://www.unboundmedicine.com/medline/citation/23201856/The_promise_of_pre_exposure_prophylaxis_with_antiretroviral_drugs_to_prevent_HIV_transmission:_a_review_ L2 - https://doi.org/10.1097/COH.0b013e32835b809d DB - PRIME DP - Unbound Medicine ER -