Gladstone Institute of Virology and Immunology and University of California, San Francisco, USA.
Clin Infect Dis. 2010 May 15;50 Suppl 3(Suppl 3):S96-101. doi: 10.1086/651479.
Prophylactic use of antimicrobial agents and microbicides has been proven for many infections, including surgical, gastrointestinal, upper respiratory, and meningococcal infections. Antiretroviral therapy for pregnant women prevents mother-to-child transmission of human immunodeficiency virus (HIV), which has become rare in settings where access to therapy is widespread. Postexposure prophylaxis after needlestick injury or significant sexual exposure is recommended on the basis of animal studies and case-control observational studies, although use of these interventions is limited to those who recognize exposure, have access, and have the power to use the interventions. Clinical trials are evaluating whether regular or preexposure use of antiretroviral therapy provides additional protection for persons at high risk of infection who are also offered standard prevention care, including HIV testing, counseling, condoms, and management of sexually transmitted infections. Trials are evaluating topical or oral use. Concerns have arisen with regard to optimal dosing strategies, costs, access, drug resistance, risk behavior, and the role of communities. Future implementation, if warranted, will be guided by the results of clinical trials in progress and engagement of communities exposed to HIV.
预防性使用抗菌药物和杀微生物剂已被证明可预防多种感染，包括手术、胃肠道、上呼吸道和脑膜炎球菌感染。抗逆转录病毒疗法可用于孕妇，以防止艾滋病毒（HIV）母婴传播，在广泛获得治疗的情况下，HIV 母婴传播已变得罕见。根据动物研究和病例对照观察性研究，建议在发生针刺伤或有重大性接触后进行暴露后预防，但这些干预措施的使用仅限于那些认识到暴露、有途径获得并有权使用干预措施的人。临床试验正在评估定期或暴露前使用抗逆转录病毒疗法是否为同时提供标准预防护理（包括 HIV 检测、咨询、避孕套和性传播感染管理）的高危感染人群提供额外保护。试验正在评估局部或口服用药。人们对最佳剂量策略、成本、可及性、耐药性、风险行为以及社区的作用存在担忧。如果有必要，未来的实施将以正在进行的临床试验结果和接触 HIV 的社区的参与为指导。
