简要报告：在参与口服暴露前预防（PrEP）预防HIV-1疗效试验的非洲HIV-1血清学不一致伴侣中，药物共享情况罕见。
Brief Report: Medication Sharing Is Rare Among African HIV-1 Serodiscordant Couples Enrolled in an Efficacy Trial of Oral Pre-exposure Prophylaxis (PrEP) for HIV-1 Prevention.
作者信息
Thomson Kerry A, Haberer Jessica E, Marzinke Mark A, Mujugira Andrew, Hendrix Craig W, Celum Connie, Ndase Patrick, Ronald Allan, Bangsberg David R, Baeten Jared M
机构信息
*Department of Epidemiology, University of Washington, Seattle, WA; †Center for Global Health and Department of Medicine, Massachusetts General Hospital, Boston, MA; ‡Departments of Pathology and Medicine, Johns Hopkins University, Baltimore, MD; §Department of Epidemiology and Biostatistics, Makerere University, Kampala, Uganda; ‖Division of Clinical Pharmacology and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; ¶Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA; #Department of Global Health, University of Washington, Seattle, WA; **Department of Medicine, University of Manitoba, Winnipeg, Canada; ††Oregon Health and Sciences University and Portland State University School of Public Health, Portland, OR; and ‡‡Departments of Global Health, Medicine, and Epidemiology, University of Washington, Seattle, WA.
出版信息
J Acquir Immune Defic Syndr. 2017 Jun 1;75(2):184-189. doi: 10.1097/QAI.0000000000001356.
Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at <0.01% of visits, and 0%-1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.
暴露前预防（PrEP）药物的共享是PrEP实施过程中的一个问题。对于HIV-1血清学不一致的伴侣来说，药物共享可能会削弱HIV-1预防效果，而且如果HIV-1感染的伴侣服用，还可能导致抗逆转录病毒耐药性。在一项针对HIV-1血清学不一致伴侣的PrEP疗效试验中，我们通过自我报告以及检测HIV-1感染伴侣血浆中的替诺福韦浓度来评估PrEP共享的发生情况。PrEP共享的自我报告发生率在就诊中低于0.01%，在随机选择的HIV-1感染参与者中，0%-1.6%的样本以及在目的选择的样本中0%的样本检测到了可检测的替诺福韦浓度（中位数：66.5 ng/mL，范围：1.3-292 ng/mL）。HIV-1血清学不一致伴侣之间的PrEP共享极为罕见。
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