HIV Preexposure Prophylaxis

Riddell, James; Amico, K. Rivet; Mayer, Kenneth H.

doi:10.1001/jama.2018.1917

Cited by 220 publications

(173 citation statements)

References 54 publications

(114 reference statements)

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“…Pre‐exposure prophylaxis (PrEP), with tenofovir disoproxil/emtricitabine, has been proven to be highly effective in preventing HIV infections in men who have sex with men (MSM) and other risk groups, both in clinical trials and observational studies . However, the appropriate use of PrEP requires exclusion of conditions contraindicated for PrEP use, including a pre‐existing HIV infection or compromised kidney function, in addition to regular monitoring of HIV status, kidney function and testing for other sexually transmitted infections (STIs) .…”

Section: Introductionmentioning

confidence: 99%

“…Current guidelines recommend HIV testing every three months, STI testing every three to six months and kidney function testing every six to twelve months . PrEP should only be initiated and maintained in HIV‐negative people to avoid improper antiviral therapy and the emergence of resistance against tenofovir disoproxil/emtricitabine . Currently, PrEP is only approved for daily dosing in the European Union , but other dosing regimens, such as on‐demand dosing or intermittent dosing, were investigated in clinical trials and are also used in practice in some European countries .…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with the informal use of HIV pre‐exposure prophylaxis in Germany: a cross‐sectional study

et al. 2019

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Introduction Until September 2019, pre‐exposure prophylaxis (PrEP) with tenofovir disoproxil/emtricitabine for HIV prevention was not covered by health insurance plans in Germany, and was only available through private prescriptions with self‐pay or through informal non‐prescription sources. The objective of this study was to investigate the proportion of informal PrEP use among PrEP users and to identify factors of public health relevance that might be associated with informal PrEP use. Methods We conducted a cross‐sectional study recruiting PrEP users independent of their PrEP source. Clients from anonymous community testing checkpoints, users of three dating apps for men who have sex with men residing in Germany and users of a PrEP community website, were recruited to complete a short anonymous online survey. Participants were recruited between 24 July and 3 September 2018. The results were analysed using univariable and multivariable logistic regressions. Results We recruited 2005 participants currently using PrEP. The median age was 38 years, and 80.3% of the participants identified themselves as male (missing: 19.1%). Overall, 71.6% obtained PrEP through medical services with a private prescription or a clinical trial, and 17.4% obtained PrEP through informal sources (missing: 11.0%). The most common informal sources were ordering online from another country (8.8%), travel abroad (3.6%), and friends (2.5%). Factors associated with informal PrEP use were on demand/intermittent dosing (adjusted OR: 3.5, 95% CI 2.5 to 5.0) and not receiving medical tests during PrEP use (adjusted OR: 3.2, 95% CI 2.0 to 5.2). In addition, informal PrEP users who did not take PrEP daily had a strongly increased risk of starting PrEP without prior medical tests (adjusted stratum‐specific OR = 31.7, 95% CI 4.6 to 219.5). Conclusions Informal PrEP use was associated with a higher risk of not getting tested before and during PrEP use, which could lead to HIV infections resistant to tenofovir and emtricitabine if people with undiagnosed HIV use PrEP. Health insurance plans that cover PrEP and the accompanying routine tests could ensure adequate medical supervision of PrEP users and reduce barriers to PrEP use. Our findings strongly support the implementation of PrEP programmes in countries with similar patterns of informal PrEP use.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors associated with the informal use of HIV pre‐exposure prophylaxis in Germany: a cross‐sectional study

et al. 2019

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“…For HIV prevention applications, an ARV implant could be used as a stand‐alone product because preexposure prophylaxis can be pursued with a single active agent . However, for HIV treatment, there would be a need for partner formulations to allow effective combination therapy to suppress viremia.…”

Section: Long‐acting Products and Formulations In Clinical Developmentmentioning

confidence: 99%

“…For HIV prevention applications, an ARV implant could be used as a stand-alone product because preexposure prophylaxis can be pursued with a single active agent. 49 However, for HIV treatment, there would be a need for partner formulations to allow effective combination therapy to suppress viremia. Ideally, a single implant could be designed to contain two or more ARVs with similar pharmacokinetic properties; alternatively, two separate implants could be inserted and replaced simultaneously.…”

Section: Antiretroviral Implantsmentioning

confidence: 99%

Modern Human Immunodeficiency Virus Therapy: Progress and Prospects

Flexner

2018

Clin Pharma and Therapeutics

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Safe and effective lifelong treatment to control human immunodeficiency virus (HIV) infection is one of the greatest scientific and public health achievements of the past century. The majority of infected individuals able to maintain a daily oral regimen now have a normal or near‐normal life expectancy. More than 30 approved drugs and dozens of formulations have produced thousands of possible drug combinations used clinically in the past, but today most patients receive only a handful of high priority and rigorously tested regimens. Unique features of antiretroviral therapy include the need for lifelong treatment to control virus replication and the possibility of rapid emergence of permanent drug resistance if these agents are not properly used. Although three‐drug combination oral regimens have radically altered the course of this epidemic, the future will include long‐acting injectable and implantable drugs and devices to treat and prevent infection.

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“…HBV coinfection with human immunodeficiency virus (HIV) puts patients at higher risk for severe liver disease, making prevention of such infections a priority . The recent evaluation of HIV pre‐exposure prophylaxis (PrEP) regimens by several groups has led to the successful implementation of PrEP programs amongst high‐risk populations . Emerging evidence supports the safe use of PrEP amongst HBV carriers .…”

Section: Introductionmentioning

confidence: 99%

Identification of hepatitis B virus genotype I in Thailand

Holzmayer

Hance

Defechereux

et al. 2018

Journal of Medical Virology

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The rare hepatitis B virus genotype I (HBV‐I) classification includes complex A/G/C/U recombinants identified amongst the individuals from China, India, Laos, and Vietnam. Herein we report the first HBV‐I specimen from Thailand, with detectable HBsAg despite a 10–amino‐acid truncation. This HBV‐I genome has a similar recombinant pattern to reference strains, including a C region that branches basal to references, suggesting a premodern era recombination event gave rise to HBV‐I. With an average sequence divergence from other genotypes ranging from 7.66% (standard deviation [SD], 0.42%; C) to 14.27% (SD, 0.31%; H), this new genome supports the HBV‐I classification as a unique genotype.

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HIV Preexposure Prophylaxis

Abstract: TDF/emtricitabine is an effective and safe therapy for preventing HIV transmission. Increasing prescription of TDF/emtricitabine for patients at risk of acquiring HIV has the potential to reduce new HIV infections.

Cited by 220 publications

References 54 publications

Factors associated with the informal use of HIV pre‐exposure prophylaxis in Germany: a cross‐sectional study

Factors associated with the informal use of HIV pre‐exposure prophylaxis in Germany: a cross‐sectional study

Modern Human Immunodeficiency Virus Therapy: Progress and Prospects

Identification of hepatitis B virus genotype I in Thailand

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