Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection
Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection
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DOI：
10.4102/sajhivmed.v17i1.455
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发表时间：
2016-03-09
影响因子：
1.7
通讯作者：
Eakles, Robyn
中科院分区：
文献类型：
--
作者：
Bekker, Linda-Gail;Rebe, Kevin;Eakles, Robyn
2012年6月，南部非洲艾滋病毒临床医生协会为有感染艾滋病毒风险的男男性行为者发布了第一套口服暴露前预防（PrEP）指南。自第一个指南发布以来，PrEP临床研究中产生了大量数据，显然有必要修订和扩大PrEP指南，因为有新的证据表明PrEP在一些人群中安全性和有效性，包括男男性行为者、变性人、异性恋男女、艾滋病毒血清不一致的夫妇和注射吸毒者。在2015年9月发布世界卫生组织（世卫组织）综合治疗指南之后，这一需求尤为重要。这些指南建议，鉴于南部非洲地区艾滋病毒的高流行率，PrEP是一种非常有效、安全的生物医学预防艾滋病毒选择，可与其他联合预防战略相结合。预防措施应针对艾滋病毒感染风险最高的人群量身定制，同时从该区域的研究中获得更多数据，以指导最佳部署，以实现区域最大影响。预防措施可以在认为有感染艾滋病毒风险的时期间歇性使用，而不是像抗逆转录病毒治疗那样持续和终身使用。个人和人群中潜在风险的识别和准确测量也值得讨论，但在本指南中没有广泛涉及。
The Southern African HIV Clinicians Society published its first set of oral pre-exposure prophylaxis (PrEP) guidelines in June 2012 for men who have sex with men (MSM) who are at risk of HIV infection. With the flurry of data that has been generated in PrEP clinical research since the first guideline, it became evident that there was a need to revise and expand the PrEP guidelines with new evidence of safety and efficacy of PrEP in several populations, including MSM, transgender persons, heterosexual men and women, HIV-serodiscordant couples and people who inject drugs. This need is particularly relevant following the World Health Organization (WHO) Consolidated Treatment Guidelines released in September 2015. These guidelines advise that PrEP is a highly effective, safe, biomedical option for HIV prevention that can be incorporated with other combination prevention strategies in Southern Africa, given the high prevalence of HIV in the region. PrEP should be tailored to populations at highest risk of HIV acquisition, whilst further data from studies in the region accrue to guide optimal deployment to realise the greatest impact regionally. PrEP may be used intermittently during periods of perceived HIV acquisition risk, rather than continually and lifelong, as is the case with antiretroviral treatment. Recognition and accurate measurement of potential risk in individuals and populations also warrants discussion, but are not extensively covered in these guidelines.