Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Molecular and Clinical Pharmacology.
AIDS. 2021 Dec 15;35(Suppl 2):S137-S143. doi: 10.1097/QAD.0000000000003102.
Long-acting antiretroviral drugs have emerged as exciting treatment and preexposure prophylaxis (PrEP) options for people with HIV and at risk of HIV. Long-acting regimens may improve dosing convenience, tolerability and cost compared with current daily-based oral therapy. They can also circumvent stigma associated with oral therapy for both treatment and PrEP, thereby improving adherence and outcomes. Yet, multiple challenges remain, many specific to low-income and middle-income countries (LMICs), where the epidemic is most concentrated and HIV prevention and treatment options are limited. To optimize the use of long-acting formulations, key outstanding questions must be addressed. Uncertain costing, scale-up manufacturing, complex delivery systems and implementation challenges are potential barriers when considering the scalability of long-acting ARVs for global use.
长效抗逆转录病毒药物已成为治疗和 HIV 暴露前预防 (PrEP) 的新选择，适用于 HIV 感染者和 HIV 高危人群。与目前基于每日口服治疗的方案相比，长效方案可能会提高给药的便利性、耐受性和经济性。它们还可以消除治疗和 PrEP 中与口服治疗相关的污名，从而提高依从性和治疗效果。然而，仍存在许多挑战，其中许多挑战是低收入和中等收入国家（LMICs）特有的，这些国家的疫情最为集中，HIV 预防和治疗方案有限。为了优化长效制剂的使用，必须解决关键的遗留问题。当考虑将长效抗逆转录病毒药物用于全球使用时，成本不确定性、扩大生产、复杂的输送系统和实施方面的挑战是潜在的障碍。
