Doblecki-Lewis Susanne, Cohen Stephanie, Liu Albert
Division of Infectious Diseases, University of Miami Miller School of Medicine, San Francisco.
Population Health Division, San Francisco Department of Health, San Francisco ; Division of Infectious Diseases, University of California, San Francisco.
Curr Treat Options Infect Dis. 2015 Jun;7(2):101-112. doi: 10.1007/s40506-015-0046-4.
Pre-exposure prophylaxis (PrEP) is an effective and evidence-based HIV-prevention option and is recommended for individuals with substantial risk for HIV infection [1]. Randomized controlled trials have demonstrated that daily oral PrEP dramatically reduces the risk of HIV infection when it is taken as directed. Concerns regarding widespread emergence of antiretroviral resistance attributable to PrEP and behavioral disinhibition have to date not been observed in clinical trials and open-label demonstration projects. PrEP has great potential as part of an HIV risk reduction strategy and barriers to wider implementation including community education, prescriber availability, and elimination of financial barriers should be aggressively pursued. Adherence is critical to PrEP efficacy and has varied across study populations; developing and refining ways of measuring and supporting adherence is essential to the success of PrEP. Evaluation of long-acting medications and alternative formulations for PrEP is underway and may lead to the wider implementation and impact of PrEP.
暴露前预防（PrEP）是一种有效且有循证依据的艾滋病毒预防方法，推荐给有高感染艾滋病毒风险的个体[1]。随机对照试验表明，每日口服PrEP按指示服用时可显著降低艾滋病毒感染风险。迄今为止，在临床试验和开放标签示范项目中尚未观察到因PrEP导致的抗逆转录病毒耐药性广泛出现以及行为抑制的问题。作为艾滋病毒风险降低策略的一部分，PrEP具有巨大潜力，应积极消除包括社区教育、开处方者可及性以及消除经济障碍等更广泛实施的障碍。依从性对PrEP疗效至关重要，且在不同研究人群中有所差异；开发和完善测量及支持依从性的方法对PrEP的成功至关重要。目前正在对长效药物和PrEP的替代剂型进行评估，这可能会使PrEP得到更广泛的实施并产生更大影响。
