Personalizing prevention: Advances in pharmacotherapy for HIV prevention.

Autor: Brizzi M; Department of Pharmacy, University of Cincinnati (UC) Health, Ohio, Cincinnati, USA., Sherman EM; Department of Pharmacy Practice, Nova Southeastern University College of Pharmacy, Florida, Ft. Lauderdale, USA.; Division of Infectious Disease, Memorial Healthcare System, Florida, Hollywood, USA., Green SB; Department of Pharmacy, Emory University Hospital, Georgia, Atlanta, USA., Nowicki DN; Investigational Drug Services, UNC Health, North Carolina, Chapel Hill, USA., Drwiega EN; Section of Infectious Diseases Pharmacotherapy, Department of ID Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Illinois, Chicago, USA., Nicol MR; Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minnesota, Minneapolis, USA., Chastain DB; University of Georgia College of Pharmacy, Georgia, Albany, USA., Sahloff EG; Department of Pharmacy Practice, University of Toledo College of Pharmacy and Pharmaceutical Sciences, Ohio, Toledo, USA., Truong WR; Department of Pharmacy, Providence St. Joseph Hospital, California, Orange, USA., Cluck D; Department of Pharmacy Practice, East Tennessee State University - Gatton College of Pharmacy, Tennessee, Johnson City, USA., Badowski ME; Section of Infectious Diseases Pharmacotherapy, Department of ID Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Illinois, Chicago, USA., Michienzi SM; Section of Infectious Diseases Pharmacotherapy, Department of ID Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Illinois, Chicago, USA., Durham SH; Department of Pharmacy Practice, Auburn University Harrison School of Pharmacy, Alabama, Auburn, USA.
Jazyk: angličtina
Zdroj: Pharmacotherapy [Pharmacotherapy] 2023 Apr; Vol. 43 (4), pp. 305-320. Date of Electronic Publication: 2023 Apr 01.
DOI: 10.1002/phar.2796
Abstrakt: The HIV epidemic continues to pose a significant burden on the healthcare system. Although the incidence of annual new infections is decreasing, health disparities persist and most new infections remain concentrated into different racial, ethnic, and minority groups. Pre-exposure prophylaxis (PrEP), which involves those at high risk of acquiring HIV to take chronic medications to prevent acquisition of the virus, is key to preventing new HIV infections. The purpose of this article is to review medication therapies for PrEP and examine their role in personalizing PrEP in different patient populations. Additionally, new medications currently under development for PrEP are reviewed, as well as treatment as prevention (TasP) and post-exposure prophylaxis (PEP). There are currently four medications available for PrEP: the oral options of co-formulated emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) or emtricitabine/tenofovir alafenamide (FTC/TAF); injectable long-acting cabotegravir (CAB-LA); and the vaginal ring dapivirine (DPV-VR). FTC/TAF is not currently indicated for persons at risk for HIV through vaginal sex due to lack of studies, but trials are currently ongoing. DPV-VR is available in Zimbabwe and South Africa and has been endorsed by the World Health Organization but is not currently available in the United States. Several agents are also in development for use in PrEP: the novel long-acting injectable lenacapavir, a first-in-class capsid inhibitor, which has no cross-resistance to any existing HIV drug class; the subdermal implant islatravir, a first-in-class translocation inhibitor; and VRC01, a broadly neutralizing antibody (bnAb) which has been evaluated in proof-of-concept studies that may lead to the development of more potent bnAbs. Overall, PrEP is highly effective at preventing HIV infection in high-risk populations. Identifying optimal PrEP regimens in different patient populations is complex and must consider patient-specific factors and medication cost and access considerations. Lastly, providers should consider individual patient preferences with regard to prevention to improve access, retention in care, and adherence.
(© 2023 The Authors. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy published by Wiley Periodicals LLC on behalf of Pharmacotherapy Publications, Inc.)
Databáze: MEDLINE
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