HIV Preexposure Prophylaxis: A Review.
|Abstract||About 40 000 Americans and 2 million people worldwide are newly infected with HIV each year. The combination antiretroviral regimen, tenofovir disoproxil fumarate (TDF)/emtricitabine, taken as a single pill once daily, has been shown to prevent HIV transmission but is used by fewer than 20% of people who could benefit in the United States.|
Daily oral tenofovir and emtricitabine-tenofovir preexposure prophylaxis reduces herpes simplex virus type 2 acquisition among heterosexual HIV-1-uninfected men and women: a subgroup analysis of a randomized trial.
|Publication Year Start||0-01-01|
PMID- 29584848 OWN - NLM STAT- In-Data-Review LR - 20180327 IS - 1538-3598 (Electronic) IS - 0098-7484 (Linking) VI - 319 IP - 12 DP - 2018 Mar 27 TI - HIV Preexposure Prophylaxis: A Review. PG - 1261-1268 LID - 10.1001/jama.2018.1917 [doi] AB - Importance: About 40000 Americans and 2 million people worldwide are newly infected with HIV each year. The combination antiretroviral regimen, tenofovir disoproxil fumarate (TDF)/emtricitabine, taken as a single pill once daily, has been shown to prevent HIV transmission but is used by fewer than 20% of people who could benefit in the United States. Observations: PubMed was searched on February 15, 2018, using the search terms pre-exposure, prophylaxis, HIV, and PrEP to identify English-language articles published between 2010 and 2018. Four placebo-controlled randomized clinical trials have demonstrated that preexposure prophylaxis (PrEP) with daily dosing of TDF/emtricitabine significantly reduces HIV acquisition in men who have sex with men, high-risk heterosexuals, and injection drug users who share injection equipment. The efficacy of daily TDF/emtricitabine exceeds 90% but is highly correlated with degree of adherence. TDF/emtricitabine is safe and well-tolerated. Only 2% of people discontinue PrEP because of adverse effects. Sexually transmitted infections are common among those using PrEP. Resistance to TDF/emtricitabine when used for PrEP is rare (<0.1%) and usually occurs when PrEP is inadvertently prescribed to individuals with undiagnosed acute HIV infection who have false-negative findings on HIV antibody/antigen testing due to HIV infection acquired within 7 to 10 days of testing. Effective methods are needed to identify individuals at high risk for acquiring HIV, ensure their access to PrEP, and maximize medication adherence. Conclusions and Relevance: TDF/emtricitabine is an effective and safe therapy for preventing HIV transmission. Increasing prescription of TDF/emtricitabine for patients at risk of acquiring HIV has the potential to reduce new HIV infections. FAU - Riddell, James 4th AU - Riddell J 4th AD - Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor. FAU - Amico, K Rivet AU - Amico KR AD - Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor. FAU - Mayer, Kenneth H AU - Mayer KH AD - The Fenway Institute, Fenway Health, Boston, Massachusetts. AD - Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts. AD - Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts. LA - eng PT - Journal Article PL - United States TA - JAMA JT - JAMA JID - 7501160 EDAT- 2018/03/28 06:00 MHDA- 2018/03/28 06:00 CRDT- 2018/03/28 06:00 PHST- 2018/03/28 06:00 [entrez] PHST- 2018/03/28 06:00 [pubmed] PHST- 2018/03/28 06:00 [medline] AID - 2676116 [pii] AID - 10.1001/jama.2018.1917 [doi] PST - ppublish SO - JAMA. 2018 Mar 27;319(12):1261-1268. doi: 10.1001/jama.2018.1917.