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长效抗 HIV 药物:治疗与预防用途

Long-Acting HIV Drugs for Treatment and Prevention.

机构信息

Division of Infectious Diseases, Weill Cornell Medicine, New York, NY 10065, USA; email:

Divisions of Clinical Pharmacology and Infectious Diseases, Long Acting/Extended Release Antiretroviral Resource Program, School of Medicine and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21287-5554, USA; email:

出版信息

Annu Rev Med. 2019 Jan 27;70:137-150. doi: 10.1146/annurev-med-041217-013717. Epub 2018 Oct 24.

Abstract

Antiretroviral drugs have revolutionized the treatment and prevention of HIV infection; however, adherence is critical for sustained efficacy. Current HIV treatment consists of three-drug regimens, and current HIV pre-exposure prophylaxis (PrEP) consists of a two-drug regimen; both generally require adherence to once-daily dosing. Long-acting formulations are useful in the treatment and prevention of other conditions (e.g., contraceptives, antipsychotics) and help promote adherence. Newer long-acting formulations of approved and investigational antiretroviral drugs in existing and newer mechanistic classes are under study for HIV treatment and prevention, including some phase III trials. Although long-acting antiretroviral drugs hold promise, some clinical challenges exist, including managing side effects, drug-drug interactions, pregnancy, and long-lasting drug concentrations that could lead to the development of drug resistance. This review aims to summarize currently available information on long-acting antiretroviral drugs for HIV treatment and prevention.

摘要

抗逆转录病毒药物彻底改变了 HIV 感染的治疗和预防方式;然而,坚持用药至关重要。目前的 HIV 治疗包括三药疗法,而目前的 HIV 暴露前预防(PrEP)包括两药疗法;两者通常都需要每天服用一次。长效制剂在其他疾病(如避孕药、抗精神病药)的治疗和预防中很有用,有助于提高用药依从性。正在研究新的长效制剂,以将现有和新型作用机制类别中已批准和正在研究的抗逆转录病毒药物用于 HIV 治疗和预防,包括一些 III 期临床试验。虽然长效抗逆转录病毒药物前景广阔,但仍存在一些临床挑战,包括管理副作用、药物相互作用、妊娠和长效药物浓度,这些可能导致耐药性的产生。本综述旨在总结目前关于长效抗逆转录病毒药物治疗和预防 HIV 的可用信息。

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