Landovitz Raphael J
University of California Los Angeles, Center for Clinical AIDS Research and Education, Los Angeles, CA, USA.
Top HIV Med. 2009 Jul-Aug;17(3):104-8.
Data supporting the efficacy of HIV postexposure prophylaxis (PEP) come largely from a small number of older studies and case reports in health care workers, studies of transmission from infected mothers to their infants, and animal studies. These data also provide support for the current recommendations regarding duration of PEP and the window of time within which PEP should be started. Although much of the available data are from experience with older 2-drug regimens, newer potent 2- and 3-drug regimens are increasingly used in occupational exposure management, and drugs with mechanisms of action targeting early events in infection (eg, entry inhibitors, integrase inhibitors) may in the future become attractive options. Nonoccupational PEP remains controversial, although its feasibility and safety have been demonstrated in a number of programs. Existing recommendations generally call for its use within 72 hours of high-risk contact with a high-risk or HIV-infected source individual. This article summarizes a presentation on PEP for HIV infection made by Raphael J. Landovitz, MD, at the IAS-USA continuing medical education course held in Los Angeles in February 2009. The original presentation is available as a Webcast at www.iasusa.org.
支持艾滋病病毒暴露后预防（PEP）有效性的数据主要来自少数针对医护人员的早期研究和病例报告、关于感染母亲向其婴儿传播的研究以及动物研究。这些数据也为当前关于PEP疗程以及应开始PEP的时间窗的建议提供了支持。尽管现有数据大多来自使用较老的两药方案的经验，但在职业暴露管理中越来越多地使用更新的强效两药和三药方案，而且作用机制针对感染早期事件的药物（如进入抑制剂、整合酶抑制剂）未来可能会成为有吸引力的选择。非职业性PEP仍然存在争议，尽管其可行性和安全性已在一些项目中得到证实。现有建议通常要求在与高危或感染艾滋病病毒的源个体进行高危接触后72小时内使用。本文总结了医学博士拉斐尔·J·兰多维茨于2009年2月在洛杉矶举行的美国国际艾滋病学会继续医学教育课程上所做的关于艾滋病病毒感染PEP的报告。原始报告可在www.iasusa.org上作为网络直播观看。
