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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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title jama
Publication Year Start




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.