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Review
. 2012 Nov;7(6):514-9.
doi: 10.1097/COH.0b013e3283582d30.

Oral antiretroviral chemoprophylaxis: current status

Jared Baeten  1 , Connie Celum
Affiliations
Review

Oral antiretroviral chemoprophylaxis: current status

Jared Baeten et al. Curr Opin HIV AIDS. 2012 Nov.

Abstract

Purpose of review: Preexposure prophylaxis (PrEP), in which HIV uninfected persons with ongoing HIV risk use oral antiretroviral medications as chemoprophylaxis against sexual HIV acquisition, is a promising new HIV prevention strategy.

Recent findings: During the past 2 years, proof-of-concept that PrEP protects against sexual HIV acquisition has been demonstrated in three clinical trials, conducted among MSM and heterosexual men and women. These trials used daily oral tenofovir disoproxil fumarate, alone or coformulated with emtricitabine. The degree of HIV protection in these trials was strongly related to the level of adherence to PrEP. Two additional clinical trials, both among heterosexual women, did not demonstrate HIV protection with PrEP, with low adherence to daily use of PrEP the leading hypothesis for lack of efficacy; adherence and biologic mechanisms for lack of efficacy in these trial populations are being evaluated.

Summary: Oral chemoprophylaxis, using tenofovir and combination emtricitabine-tenofovir, is effective for prevention of sexual HIV transmission. Next steps in the field include rigorous evaluation of uptake and adherence to PrEP in implementation settings.

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References

    1. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, et al. Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine. 2011;365:493–505. This randomized clinical trial provided definitive evidence that use of antiretroviral treatment by HIV infected persons results in substantial reduction in infectiousness and risk of HIV transmission to sexual partner (96% relative risk reduction, mediated through high adherence and viral suppression). Use of antiretroviral medications for treatment of HIV infected persons to reduce infectiousness and pre-exposure prophylaxis for HIV uninfected persons to reduce susceptibility are complementary prevention strategies.

    1. Cohen MS, Gay C, Kashuba AD, Blower S, Paxton L. Narrative review: antiretroviral therapy to prevent the sexual transmission of HIV-1. Annals of Internal Medicine. 2007;146:591–601. - PubMed
    1. 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. - PubMed
    1. 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 Medicine. 2008;5:e28. - PMC - PubMed
    1. Garcia-Lerma JG, Cong ME, Mitchell J, Youngpairoj AS, Zheng Q, et al. Intermittent prophylaxis with oral truvada protects macaques from rectal SHIV infection. Science Translational Medicine. 2010;2:14ra4. - PubMed

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