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男男性行为人群应用口服替诺福韦酯/恩曲他滨预防 HIV:斯洛文尼亚国家示范项目。

Pre-exposure prophylaxis for HIV with oral tenofovir disoproxil fumarate/emtricitabine in men who have sex with men: Slovenian national demonstration project.

机构信息

Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Int J STD AIDS. 2021 Oct;32(11):1060-1065. doi: 10.1177/09564624211019876. Epub 2021 May 18.

DOI:10.1177/09564624211019876
PMID:34006161
Abstract

Prevalence of HIV in Slovenia is low, and men who have sex with men (MSM) have the highest risk for infection. Rates of enrolment into HIV care, initiation of antiretroviral therapy and reaching an undetectable viral load in HIV-infected patients are very high. Prevention of HIV infection for MSM with PrEP is not formally available in Slovenia. The aim of this study was to demonstrate possible implementation of PrEP in Slovenia. Sixty-nine ( = 69) MSM with increased risk for HIV received PrEP with oral tenofovir disproxil fumarate /emtricitabine and acquisition were followed for a mean of 566.6 days. They had 71 episodes of STIs (incidence 61.7 per 100 person-years). No one got acquired HIV infection. Estimated glomerular filtration rate (EGFR) was significantly lower 4 ( = 0.014) and 19 ( = 0.021) months after inclusion; however, there was no clinically significant renal failure (mean EGFR 110-115 mL/min). Self-reported body weight significantly increased after 7 months ( < 0.05). Overall EGFR and self-reported body weight did not change significantly. No significant change in adherence (overall mean 81.0%; 95% CI 77.5%-84.6%; = 0.728), condom use ( = 0.077) and number of sexual partners (overall mean 2.36 per 30 days; 95% CI 2.06 to 2.65; = 0.235) was found throughout the study. Participants reported 110 graded adverse effects (AE), 104 (94.5%) grade 1-2 and 6 (5.5%) grade 3-4. No participant discontinued PrEP due to AE. The study showed successful implementation of PrEP among MSM at high risk for HIV infection in Slovenia. Based on the results of our study, PrEP should be formally available in Slovenia.

摘要

斯洛文尼亚的 HIV 感染率较低,男男性行为者(MSM)感染 HIV 的风险最高。HIV 感染者接受 HIV 护理、开始抗逆转录病毒治疗和达到病毒载量不可检测的比例非常高。斯洛文尼亚尚未正式提供 MSM 人群使用 PrEP 预防 HIV 感染。本研究旨在展示在斯洛文尼亚实施 PrEP 的可能性。69 名 HIV 感染风险增加的 MSM 接受了口服替诺福韦二吡呋酯/恩曲他滨预防治疗,并对他们进行了平均 566.6 天的随访,以观察性传播感染(STI)的发生情况。在研究期间,共有 71 名参与者发生了 STI(发病率为 61.7/100 人年)。没有一人感染 HIV。纳入后 4 个月( = 0.014)和 19 个月( = 0.021),估算肾小球滤过率(eGFR)显著降低;然而,没有出现临床显著的肾功能衰竭(平均 eGFR 为 110-115 mL/min)。7 个月后,自我报告的体重显著增加( < 0.05)。总体 eGFR 和自我报告的体重没有显著变化。依从性(总体平均 81.0%;95%CI 77.5%-84.6%; = 0.728)、安全套使用率( = 0.077)和性伴侣数量(总体平均 30 天 2.36 次;95%CI 2.06-2.65; = 0.235)在整个研究期间均无显著变化。参与者报告了 110 种不同的不良反应(AE),其中 104 种(94.5%)为 1-2 级,6 种(5.5%)为 3-4 级。没有参与者因 AE 而停止使用 PrEP。本研究表明,在斯洛文尼亚,HIV 感染风险较高的 MSM 中成功实施了 PrEP。基于我们的研究结果,斯洛文尼亚应正式提供 PrEP。

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