Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Suite GB, Boston, MA, USA,
Curr Infect Dis Rep. 2012 Apr;14(2):185-93. doi: 10.1007/s11908-012-0242-z.
With an estimated 2.6 million new HIV infections diagnosed annually, the world needs new prevention strategies to partner with condom use, harm reduction approaches for injection drug users, and male circumcision. Antiretrovirals can reduce the risk of mother-to-child HIV transmission and limit HIV acquisition after occupational exposure. Macaque models and clinical trials demonstrate efficacy of oral or topical antiretrovirals used prior to HIV exposure to prevent HIV transmission, ie pre-exposure prophylaxis (PrEP). Early initiation of effective HIV treatment in serodiscordant couples results in a 96% decrease in HIV transmission. HIV testing to determine serostatus and identify undiagnosed persons is foundational to these approaches. The relative efficacy of different approaches, adherence, cost and long-term safety will affect uptake and impact of these strategies. Ongoing research will help characterize the role for oral and topical formulations and help quantify potential benefits in sub-populations at risk for HIV acquisition.
每年估计有 260 万例新的 HIV 感染病例，世界需要新的预防策略，与 condom 使用、注射吸毒者的减少伤害方法以及男性割礼合作。抗逆转录病毒药物可以降低母婴 HIV 传播的风险，并限制职业暴露后的 HIV 获得。猕猴模型和临床试验证明，在 HIV 暴露前使用口服或局部抗逆转录病毒药物的有效性，可预防 HIV 传播，即预先暴露预防（PrEP）。在血清不一致的夫妇中早期开始有效的 HIV 治疗可使 HIV 传播降低 96%。HIV 检测以确定血清状态和识别未确诊者是这些方法的基础。不同方法的相对疗效、依从性、成本和长期安全性将影响这些策略的采用和影响。正在进行的研究将有助于确定口服和局部制剂的作用，并帮助定量分析在有 HIV 感染风险的亚人群中潜在的益处。
