Soriano Vicente, Treviño Ana, de Mendoza Carmen, Moreno-Torres Víctor, Pintos Ilduara, Barreiro Pablo, Corral Octavio
UNIR Health Sciences School & Medical Center, Pozuelo de Alarcón, Madrid, Spain.
Puerta de Hierro Research Institute & University Hospital, Majadahonda, Madrid, Spain.
Infez Med. 2022 Sep 1;30(3):362-371. doi: 10.53854/liim-3003-5. eCollection 2022.
The battle against human viral infections has historically relied on two medical strategies, namely vaccines to protect from contagion and antivirals to treat infected patients. In the absence of vaccines, antivirals have occasionally been used as peri-exposure prophylaxis, given either before (pre-exposure prophylaxis) or right after (post-exposure prophylaxis). In an unprecedented way, the use of antiretrovirals as chemoprophylaxis has triumphed in the HIV field. Indeed, oral antiretrovirals given either daily or at demand to HIV-uninfected individuals engaged in high-risk behaviors protect from contagion. More recently, the advent of long-acting formulations has allowed HIV protection following intramuscular injections every three months. Can we envision a similar prophylactic strategy for other human viral infections? The advent of such 'chemical vaccines' would fill an unmet need when classical vaccines do not exist, cannot be recommended, immune responses are suboptimal, escape mutants emerge or immunity wanes. In this review, we discuss the opportunities for antiviral chemoprophylaxis for viral hepatitis B and C, retroviruses HTLV-1 and HIV-2, and respiratory viruses influenza and SARS-CoV-2, among others.
历史上，对抗人类病毒感染的斗争依赖于两种医学策略，即通过疫苗预防感染以及使用抗病毒药物治疗感染患者。在没有疫苗的情况下，抗病毒药物偶尔会被用作暴露前后的预防手段，即在暴露前（暴露前预防）或暴露后立即（暴露后预防）使用。以一种史无前例的方式，抗逆转录病毒药物作为化学预防手段在艾滋病毒领域取得了成功。事实上，对于从事高风险行为的未感染艾滋病毒个体，每日或按需服用口服抗逆转录病毒药物可预防感染。最近，长效制剂的出现使得每三个月进行一次肌肉注射就能预防艾滋病毒感染。我们能否设想针对其他人类病毒感染采取类似的预防策略呢？当不存在经典疫苗、不推荐使用经典疫苗、免疫反应欠佳、出现逃逸突变体或免疫力下降时，这类“化学疫苗”的出现将满足尚未得到满足的需求。在这篇综述中，我们讨论了针对乙型和丙型病毒性肝炎、逆转录病毒人类嗜T淋巴细胞病毒1型和2型以及呼吸道病毒流感和严重急性呼吸综合征冠状病毒2型等进行抗病毒化学预防的机会。
