HIV treatment as prevention and HPTN 052

Abstract

Purpose of review This review summarizes the development and implementation of a large clinical trial, HIV Prevention Trials Network (HPTN) 052, whose initial results were recently presented and published. Recent findings A randomized, clinical trial demonstrated that antiretroviral therapy reduces the sexual transmission of HIV in HIV-serodiscordant couples by more than 96%. The logistical challenges in preparing for and conducting such a trial were considerable. Summary HPTN 052 required many years of preparation, considerable collaboration between National Institute of Health and six pharmaceutical companies, and careful ongoing consideration of a large number of ethical issues. HPTN 052 revealed the magnitude of benefit when using antiretroviral therapy to prevent the transmission of HIV, and served as proof of a concept. The results have proven central to the development of new global HIV-prevention efforts.

Anti-Retroviral–Based HIV Pre-Exposure Prophylaxis for Women: Recent Advances and Next Steps

“…In stable partnerships, condom use is low, and women are often unaware of their partner's HIV status [19]. Therefore, a need exists for HIV prevention methods that Multiple studies of PrEP have shown that oral ARVs, when used consistently, reduce the risk of HIV infection in people who are at high risk by up to 92% including among women [5]. Currently, FTC-TDF is the medication with a label indication as PrEP against HIV acquisition recommended by the World Health Organization (WHO) and the United States Centers of Diseases Control and Prevention [20,21].…”

“…For HIV uninfected women in known serodiscorant partnership, initiation and sustained use of ART by their infected male paterns are another highly efective prevention options for couples [5]. Women who want to conceive or with HIV positive partners who have not yet initiated ART, PrEP as bridge to ART prevention strategy is an atractive and highly efective HIV option.…”

“…While existing HIV-1 prevention interventions including behavior change, use of male and female condoms, treatment of sexually transmited infections (STIs), male circumcision, and uptake of antiretroviral (ARV) treatment to reduce the infectiousness of persons with HIV-1 have gone a long way in controlling the spread of HIV-1 infection [2][3][4][5][6], HIV-1 rates in young women in resource limited setings remain unacceptably high [1]. This is in part, because many HIV-1 prevention methods require the participation or consent of a male partner.…”

Neuropsychiatric effects of tenofovir in comparison with other antiretroviral drugs

“…[9][10][11] Additionally, in 2011 the HPTN 052 trial conducted by the HIV Prevention Trials Network in the US, showed that use of a TDF-containing regimen in an HIV-positive partner resulted in a 96% reduction in transmission risk. 12 This study formed the basis for the concept of treatment as prevention, which has subsequently led to several studies investigating the safety and efficacy of using a TDF-containing regimen in noninfected individuals for PrEP.…”

Diferenças e similaridades entre mulheres que vivem e não vivem com HIV: aportes do estudo GENIH para a atenção à saúde sexual e reprodutiva

“…In the area of care and treatment, access and adherence to antiretroviral therapy (ART) have increased the survival of persons living with HIV/AIDS (PLWA) 2 and reduced the risk of mother-to-child transmission for HIV-positive women 3,4 , thus increasing the likelihood that they will consider becoming mothers after learning of their serological status. More recently, the HTPN052 clinical trial in 2012 showed that early use of ART reduces sexual transmission of HIV by more than 96% in serodiscordant couples 5 .…”