MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
Bill and Melinda Gates Foundation, Seattle, Washington, USA.
J Infect Dis. 2021 Oct 13;224(7):1179-1186. doi: 10.1093/infdis/jiaa296.
Although effective, some oral pre-exposure prophylaxis (PrEP) users face barriers to adherence using daily pills, which could be reduced by long-acting formulations. Long-acting cabotegravir (CAB LA) is a potential new injectable formulation for human immunodeficiency virus (HIV) PrEP being tested in phase III trials.
We use a mathematical model of the HIV epidemic in South Africa to simulate CAB LA uptake by population groups with different levels of HIV risk. We compare the trajectory of the HIV epidemic until 2050 with and without CAB LA to estimate the impact of the intervention.
Delivering CAB LA to 10% of the adult population could avert more than 15% of new infections from 2023 to 2050. The impact would be lower but more efficient if delivered to populations at higher HIV risk: 127 person-years of CAB LA use would be required to avert one HIV infection within 5 years if used by all adults and 47 person-years if used only by the highest risk women.
If efficacious, a CAB LA intervention could have a substantial impact on the course of the HIV epidemic in South Africa. Uptake by those at the highest risk of infection, particularly young women, could improve the efficiency of any intervention.
尽管有效，但一些口服暴露前预防（PrEP）使用者在使用每日药丸时面临着依从性障碍，长效制剂可以减少这些障碍。长效卡替拉韦（CAB LA）是一种新的潜在长效注射制剂，正在进行 III 期临床试验，用于人类免疫缺陷病毒（HIV）PrEP。
我们使用南非艾滋病毒流行的数学模型，模拟不同 HIV 风险人群对 CAB LA 的使用情况。我们比较了有和没有 CAB LA 的情况下，到 2050 年艾滋病毒流行的轨迹，以估计干预措施的影响。
从 2023 年到 2050 年，向 10%的成年人口提供 CAB LA，可避免超过 15%的新感染。如果向 HIV 风险较高的人群提供 CAB LA，其影响将较低但更有效：如果所有成年人都使用 CAB LA，需要 127 人年的 CAB LA 使用量才能在 5 年内避免一人感染 HIV，如果仅高危女性使用，需要 47 人年的 CAB LA 使用量。
如果有效，CAB LA 干预措施可能会对南非艾滋病毒流行的进程产生重大影响。感染风险最高的人群（特别是年轻女性）的参与可以提高任何干预措施的效率。
