The Promise of Antiretrovirals for HIV Prevention
- PMID: 22351302
- PMCID: PMC3901012
- DOI: 10.1007/s11908-012-0242-z
The Promise of Antiretrovirals for HIV Prevention
Abstract
With an estimated 2.6 million new HIV infections diagnosed annually, the world needs new prevention strategies to partner with condom use, harm reduction approaches for injection drug users, and male circumcision. Antiretrovirals can reduce the risk of mother-to-child HIV transmission and limit HIV acquisition after occupational exposure. Macaque models and clinical trials demonstrate efficacy of oral or topical antiretrovirals used prior to HIV exposure to prevent HIV transmission, ie pre-exposure prophylaxis (PrEP). Early initiation of effective HIV treatment in serodiscordant couples results in a 96% decrease in HIV transmission. HIV testing to determine serostatus and identify undiagnosed persons is foundational to these approaches. The relative efficacy of different approaches, adherence, cost and long-term safety will affect uptake and impact of these strategies. Ongoing research will help characterize the role for oral and topical formulations and help quantify potential benefits in sub-populations at risk for HIV acquisition.
References
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- Centers for Disease Control and Prevention: High-Impact HIV Prevention [Accessed November 2011];CDC’s Approach to Reducing HIV Infections in the United States. 2011 Available at http://www.cdc.gov/hiv/strategy/dhap/pdf/nhas_booklet.pdf.
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- [Accessed November 2011];UNAIDS Report on the Global AIDS Epidemic. http://www.unaids.org/GlobalReport/default.htm]
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Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505. This reference reports the results of a multinational, randomized controlled trial, HPTN-052, in which immediate initiation of antiretroviral therapy by the HIV-infected member of HIV serodiscordant couples reduced the risk of HIV transmission to their HIV-uninfected partner by 96%, as compared to delaying antiretroviral therapy until a CD4 count of 250 cells/microliter or less was obtained.
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- Cardo DM, Culver DH, Ciesielski CA, et al. A case–control study of HIV seroconversion in health care workers after percutaneous exposure. N Engl J Med. 1997;337(21):1485–90. - PubMed
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