Nicol Melanie R, Adams Jessica L, Kashuba Angela Dm
Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Kerr Hall 3317, CB#7569, Chapel Hill, NC 27519-7569, (P) 919-843-0321, (F) 919-962-0644.
Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, 600 South 43rd Street, Philadelphia, PA 19104-4495, (P) 215-596-8759.
Clin Investig (Lond). 2013 Mar;3(3). doi: 10.4155/cli.12.155.
The global HIV epidemic cannot be controlled by current treatment or prevention strategies. Pre-exposure prophylaxis (PrEP) using antiretrovirals is a promising approach to curbing the spread of HIV transmission. Recently, four clinical trials demonstrated favorable results when antiretroviral PrEP was administered topically or orally. However, two additional trials were unable to demonstrate a benefit, indicating that further study is required to define the populations and conditions under which PrEP will be effective. Adherence is highly correlated with protection, yet the exact level of adherence required is unknown. Future studies may require increased drug exposure testing and more objective methods to monitor adherence in real-time. Although the development of drug resistance in the PrEP trials has been low, it remains a concern, as therapeutic options could be compromised for those who seroconvert while on PrEP.
当前的治疗或预防策略无法控制全球范围内的艾滋病毒流行。使用抗逆转录病毒药物进行暴露前预防（PrEP）是遏制艾滋病毒传播的一种有前景的方法。最近，四项临床试验表明，局部或口服抗逆转录病毒PrEP时效果良好。然而，另外两项试验未能证明其益处，这表明需要进一步研究来确定PrEP有效的人群和条件。依从性与保护效果高度相关，但所需的确切依从水平尚不清楚。未来的研究可能需要增加药物暴露测试，并采用更客观的方法来实时监测依从性。虽然PrEP试验中耐药性的产生率较低，但它仍然是一个问题，因为对于在PrEP治疗期间血清转化的人来说，治疗选择可能会受到影响。
