Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Radiation Oncology Department, Radiation Oncology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
J Clin Pharmacol. 2021 May;61(5):581-590. doi: 10.1002/jcph.1788. Epub 2020 Dec 6.
Although people living with human immunodeficiency virus and other comorbidities are expected to experience more grievous consequences with corona virus disease 2019 (COVID-19), recent cohort studies did not indicate this. Antiretrovirals (ARVs) might have a prophylactic role in these patients. The purpose of this study was to review the most recently published articles on the possible role of ARVs for pre- or postexposure prophylaxis against COVID-19. From June to October 2020, we searched scientific databases using specific key words to identify ongoing trials or articles published before October 2020 investigating any subgroups of ARVs for prophylaxis against COVID-19. Apart from molecular docking studies, in vitro, animal, and human studies are very limited for evaluating the prophylactic role of ARVs against severe acute respiratory syndrome-corona virus 2 (SARS-CoV-2) infection. According to our findings, there is no definite evidence to support use of protease inhibitors for this purpose, despite the promising results of molecular studies and limited clinical evidence for ritonavir-boosted lopinavir, darunavir, and nelfinavir when used early in the course of the disease. Nucleotide/nucleoside reverse-transcriptase inhibitors (NRTI) also have shown binding affinity to main enzymes of SARS-CoV-2 in molecular, in vitro, and animal studies. NRTIs like tenofovir and emtricitabine might exhibit a prophylactic role against SARS-CoV-2 infection. In conclusion, currently there is no evidence to justify the use of ARVs for prophylaxis against COVID-19.
虽然感染人类免疫缺陷病毒（HIV）和其他合并症的人群预计会因 2019 年冠状病毒病（COVID-19）遭受更严重的后果，但最近的队列研究并未表明这一点。抗逆转录病毒药物（ARV）可能在这些患者中具有预防作用。本研究旨在回顾最近发表的关于 ARV 用于 COVID-19 暴露前或暴露后预防的可能作用的文章。2020 年 6 月至 10 月，我们使用特定关键词搜索科学数据库，以确定正在进行的试验或 2020 年 10 月之前发表的调查任何 ARV 亚组用于预防 COVID-19 的文章。除了分子对接研究外，评估 ARV 预防严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的作用的体外、动物和人体研究非常有限。根据我们的发现，尽管分子研究结果有希望，而且利托那韦增强洛匹那韦、达芦那韦和奈韦拉平在疾病早期使用时的有限临床证据表明，使用蛋白酶抑制剂对此没有明确的证据支持。核苷酸/核苷逆转录酶抑制剂（NRTI）在分子、体外和动物研究中也显示出对 SARS-CoV-2 主要酶的结合亲和力。NRTI 如替诺福韦和恩曲他滨可能在预防 SARS-CoV-2 感染方面发挥作用。总之，目前没有证据表明 ARV 可用于预防 COVID-19。
