Brief Report: Preventing HIV-1 Infection in Women Using Oral Preexposure Prophylaxis: A Meta-analysis of Current Evidence.
Brief Report: Preventing HIV-1 Infection in Women Using Oral Preexposure Prophylaxis: A Meta-analysis of Current Evidence.
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DOI：
10.1097/qai.0000000000001160
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发表时间：
2016-12-15
期刊：
影响因子：
--
通讯作者：
Donnell DJ
中科院分区：
文献类型：
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作者：
Hanscom B;Janes HE;Guarino PD;Huang Y;Brown ER;Chen YQ;Hammer SM;Gilbert PB;Donnell DJ
世界卫生组织发布了其抗逆转录病毒指南的早期版本，其中建议将PrEP（每日口服固定剂量复方替诺福韦酯富马酸酯/恩曲他滨（TDF/FTC）形式的暴露前预防）作为所有有感染艾滋病毒重大风险的人的预防选择。然而，两项主要的仅限女性的PrEP试验（VOICE和FEM PrEP）缺乏有效性，仍然是对南部非洲妇女实现有效性的担忧。我们对女性口服TDF/FTC的有效性进行了一系列荟萃分析，包括所有五项包含女性的随机安慰剂对照试验。一项基于依从性的荟萃分析模型显示，在依从性水平较高（75%）的情况下，口服PrEP估计是有效的（RR=0.39，95% CI 0.25至0.60）。如果这些结果适用于南部非洲的妇女，那么该地区未来的预防试验设计应该考虑到当PrEP可用时可能降低的艾滋病毒发病率。
The World Health Organization has issued an early release revision to its antiretroviral guidelines in which PrEP (Pre-exposure prophylaxis in the form of daily oral, fixed dose combination tenofovir disoproxil fumarate/emtricitabine (TDF/FTC)) is recommended as a prevention option to all people at substantial risk of acquiring HIV. However, lack of effectiveness in two major women-only PrEP trials, VOICE and FEM PrEP, continue to be a cause for concern about achieving effectiveness for women in Southern Africa. We conducted a series of meta-analyses of oral TDF/FTC effectiveness in women including all five randomized placebo-controlled trials that included women. An adherence-based meta-analysis model showed that with high levels of adherence (75%), oral PrEP is estimated to be effective (RR=0.39, 95% CI 0.25 to 0.60). Provided that these results apply to women in Southern Africa, future prevention trial designs in that region should account for potentially reduced HIV incidence when PrEP is available.