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暴露前预防(PrEP)预防人类免疫缺陷病毒:一种初级实践方法。

Pre-exposure Prophylaxis (PrEP) For Prevention of Human Immunodeficiency Virus: A Primary Practice Approach.

作者信息

Sattar Beena, Beach Robin, Johnson Philip C

机构信息

Division of General Medicine, Department of Internal Medicine, McGovern Medical School, Houston, TX, USA.

出版信息

J Gen Intern Med. 2025 Mar 7. doi: 10.1007/s11606-025-09437-2.

Abstract

Acquired immunodeficiency syndrome (AIDS) is a chronic immune system disease caused by human immunodeficiency virus (HIV), first reported in 1981, and continues to interfere with the body's ability to fight infection and disease. There is no cure for HIV/AIDS, but medication can control infection and prevent disease progression. Pre-exposure prophylaxis (PrEP) taken orally, or as intramuscular injection, is safe and effective in reducing the chances of acquiring HIV. United States Preventive Services Task Force (U.S.P.S.T.F.) and Center of Disease Control and Prevention (CDC) guidelines recommend providing behavioral counseling as well as prescribing PrEP for all sexually active adolescents and adults to decrease risk of HIV acquisition. In light of the United States (U.S.) Department of Health and Human Services (DHHS) goal for ending the HIV epidemic, all healthcare providers should be familiar with recommending PrEP as indicated to aid in disease eradication. The goal is to reduce new HIV infections in the U.S. by 75% in 2025 and 90% in 2030. In 2021, CDC data showed 30% of people who could benefit from PrEP were prescribed medication, an improvement from 13% in 2017. Although progress has been made in preventing and treating HIV, prevention efforts must further improve to reach all populations equitably to achieve a national PrEP coverage goal of 50%, by the end of this year, 2025. In this review, we highlight the urgency for all healthcare providers to offer PrEP to their sexually active patients, we provide the supportive data behind PrEP use, and we guide the clinician through safely ordering and monitoring its use in routine patient care. Continued education for providers and the public will help facilitate early intervention and better management to end the HIV epidemic.

摘要

获得性免疫缺陷综合征(艾滋病)是一种由人类免疫缺陷病毒(HIV)引起的慢性免疫系统疾病,于1981年首次报告,它持续干扰人体抵抗感染和疾病的能力。目前尚无治愈HIV/艾滋病的方法,但药物可以控制感染并预防疾病进展。口服或肌肉注射的暴露前预防(PrEP)在降低感染HIV的几率方面是安全有效的。美国预防服务工作组(U.S.P.S.T.F.)和疾病控制与预防中心(CDC)的指南建议,为所有性活跃的青少年和成年人提供行为咨询并开具PrEP处方,以降低感染HIV的风险。鉴于美国卫生与公众服务部(DHHS)终结HIV流行的目标,所有医疗保健提供者都应熟悉按指征推荐PrEP,以助力疾病根除。目标是到2025年将美国新的HIV感染病例减少75%,到2030年减少90%。2021年,CDC的数据显示,30%可从PrEP中受益的人获得了药物处方,这一比例高于2017年的13%。尽管在预防和治疗HIV方面已取得进展,但预防工作仍须进一步改进,以公平地覆盖所有人群,到2025年底实现全国PrEP覆盖率达到50%的目标。在本综述中,我们强调所有医疗保健提供者向其性活跃患者提供PrEP的紧迫性,我们提供PrEP使用背后的支持性数据,并指导临床医生在常规患者护理中安全地开具和监测其使用情况。对提供者和公众的持续教育将有助于促进早期干预和更好的管理,以终结HIV流行。

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