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HIV 暴露前预防:应对艾滋病流行的新型和即将面世的药物。

HIV Pre-Exposure Prophylaxis: New and Upcoming Drugs to Address the HIV Epidemic.

机构信息

Section of Infectious Diseases, HIV Program, Mayo Clinic, Rochester, MN, USA.

Department of Pharmacy, Mayo Clinic, Rochester, MN, USA.

出版信息

Drugs. 2023 Dec;83(18):1677-1698. doi: 10.1007/s40265-023-01963-9. Epub 2023 Dec 11.

DOI:10.1007/s40265-023-01963-9
PMID:38079092
Abstract

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) provides a critical intervention toward ending the HIV epidemic and protecting people with reasons to utilize PrEP. PrEP options continue to expand as new administration modalities offer the potential to tailor PrEP use for individual success. We have provided the evidence for new and emerging antiretroviral agents for PrEP (cabotegravir, lenacapavir, dapivirine, and broadly neutralizing antibodies), divided into pharmacology, animal model, and human data, accompanied by a summary and suggested place in therapy. Cabotegravir is a US Food and Drug Administration (FDA)-approved intramuscular injection given every 2 months with a strong body of evidence demonstrating efficacy for HIV PrEP, lenacapavir administered subcutaneously every 6 months is currently under investigation for HIV PrEP, dapivirine vaginal ring is an available PrEP option for women in certain areas of Africa, and broadly neutralizing monoclonal antibodies have been challenged in demonstrating efficacy in phase 1-2 study for HIV PrEP to date. Clinical literature for individual agents is discussed with data from major studies summarized in tables. This review provides a detailed overview of recently available and premier candidate PrEP drugs.

摘要

人类免疫缺陷病毒(HIV)暴露前预防(PrEP)是终结 HIV 流行和保护有理由使用 PrEP 的人群的重要干预措施。随着新的给药方式为 PrEP 的个体化成功应用提供了潜力,PrEP 的选择不断增加。我们提供了新出现的抗逆转录病毒药物用于 PrEP 的证据(卡替拉韦、拉替拉韦、地匹福林和广泛中和抗体),分为药理学、动物模型和人体数据,并附有摘要和治疗建议。卡替拉韦是一种美国食品和药物管理局(FDA)批准的每 2 个月肌内注射一次的药物,有大量证据表明其对 HIV PrEP 有效,拉替拉韦每 6 个月皮下注射一次,目前正在研究用于 HIV PrEP,地匹福林阴道环是非洲某些地区女性可用的 PrEP 选择,广泛中和单克隆抗体在 HIV PrEP 的 1-2 期研究中证明疗效方面一直面临挑战。本文详细介绍了最近可用的和主要的 PrEP 候选药物,并讨论了各个药物的临床文献,总结在表格中。

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HIV Pre-Exposure Prophylaxis: New and Upcoming Drugs to Address the HIV Epidemic.HIV 暴露前预防:应对艾滋病流行的新型和即将面世的药物。
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Front Public Health. 2025 Jun 26;13:1600773. doi: 10.3389/fpubh.2025.1600773. eCollection 2025.
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Considerations for capsid-targeting antiretrovirals in pre-exposure prophylaxis.暴露前预防中衣壳靶向抗逆转录病毒药物的考量因素。
Trends Mol Med. 2025 Feb 27. doi: 10.1016/j.molmed.2025.01.013.
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State of the ART (antiretroviral therapy): Long-acting HIV-1 therapeutics.

本文引用的文献

1
Pharmacogenomic panel testing provides insight and enhances medication management in people with HIV.药物基因组学面板检测为 HIV 感染者提供了深入了解和增强药物管理的机会。
AIDS. 2023 Aug 1;37(10):1525-1533. doi: 10.1097/QAD.0000000000003598. Epub 2023 May 11.
2
HIV RNA Screening Reduces Integrase Strand Transfer Inhibitor Resistance Risk in Persons Receiving Long-Acting Cabotegravir for HIV Prevention.HIV RNA 筛查可降低接受长效卡替拉韦用于 HIV 预防人群中整合酶抑制剂耐药风险。
J Infect Dis. 2022 Dec 13;226(12):2170-2180. doi: 10.1093/infdis/jiac415.
3
Safety and antiviral activity of triple combination broadly neutralizing monoclonal antibody therapy against HIV-1: a phase 1 clinical trial.
抗逆转录病毒疗法(ART)的现状:长效HIV-1治疗药物
Glob Health Med. 2024 Oct 31;6(5):285-294. doi: 10.35772/ghm.2024.01049.
4
Breakthrough Acute HIV Infections among Pre-Exposure Prophylaxis Users with High Adherence: A Narrative Review.突破性急性 HIV 感染在高依从性的暴露前预防用药者中的发生:一项叙述性综述。
Viruses. 2024 Jun 12;16(6):951. doi: 10.3390/v16060951.
三重组合广泛中和单克隆抗体疗法治疗 HIV-1 的安全性和抗病毒活性:一项 1 期临床试验。
Nat Med. 2022 Jun;28(6):1288-1296. doi: 10.1038/s41591-022-01815-1. Epub 2022 May 12.
4
Capsid Inhibition with Lenacapavir in Multidrug-Resistant HIV-1 Infection.利纳卡帕韦治疗多种药物耐药 HIV-1 感染时对衣壳的抑制作用。
N Engl J Med. 2022 May 12;386(19):1793-1803. doi: 10.1056/NEJMoa2115542.
5
Cabotegravir for the prevention of HIV-1 in women: results from HPTN 084, a phase 3, randomised clinical trial.卡博特韦用于女性艾滋病毒 1 型的预防:来自 HPTN 084 的结果,一项 3 期、随机临床试验。
Lancet. 2022 May 7;399(10337):1779-1789. doi: 10.1016/S0140-6736(22)00538-4. Epub 2022 Apr 1.
6
Characterization of Human Immunodeficiency Virus (HIV) Infections in Women Who Received Injectable Cabotegravir or Tenofovir Disoproxil Fumarate/Emtricitabine for HIV Prevention: HPTN 084.在接受注射用卡替拉韦或替诺福韦艾拉酚胺/恩曲他滨用于 HIV 预防的女性中人类免疫缺陷病毒(HIV)感染的特征:HPTN 084。
J Infect Dis. 2022 May 16;225(10):1741-1749. doi: 10.1093/infdis/jiab576.
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HIV-1 drug resistance among individuals who seroconverted in the ASPIRE dapivirine ring trial.在 ASPIRE 地昔洛韦环试验中血清转换的个体中 HIV-1 耐药性。
J Int AIDS Soc. 2021 Nov;24(11):e25833. doi: 10.1002/jia2.25833.
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Cabotegravir for HIV Prevention in Cisgender Men and Transgender Women.卡博特韦用于预防顺性别男性和跨性别女性中的 HIV。
N Engl J Med. 2021 Aug 12;385(7):595-608. doi: 10.1056/NEJMoa2101016.