Antiretrovirals and safer conception for HIV-serodiscordant couples.
Antiretrovirals and safer conception for HIV-serodiscordant couples.
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DOI：
10.1097/coh.0b013e328358bac9
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发表时间：
2012-11
影响因子：
4.1
通讯作者：
Cohan D
中科院分区：
文献类型：
--
作者：
Matthews LT;Smit JA;Cu-Uvin S;Cohan D
许多感染艾滋病毒的男女及其未感染的伴侣试图怀孕。可以应用艾滋病毒预防科学来减少性传播风险，同时尊重夫妇的生殖目标。在这里，我们讨论抗逆转录病毒药物作为预防的背景下，更安全的概念，艾滋病毒血清不一致的夫妇。对受感染的伴侣进行抗逆转录病毒治疗（ART），对未受感染的伴侣进行暴露前预防（PrEP），可降低异性性传播艾滋病毒的风险。几个示范项目表明，抗逆转录病毒药物作为艾滋病毒血清不一致夫妇的围产期艾滋病毒预防药物是可行和可接受的。应用抗逆转录病毒药物降低围受孕风险可能会受到依从性的限制。对于无法进行精子处理的男性感染（M+F−）夫妇和不愿意在没有性交的情况下进行授精的女性感染（F+M−）夫妇，对受感染的伴侣进行ART，对未受感染的伴侣进行PrEP，结合性传播感染的治疗，将性行为限制在生育高峰期，以及医学男性包皮环切术（对于F+M夫妇）提供了极好的，耐受性良好的选择，以降低围产期HIV性传播的风险。
Many men and women living with HIV and their uninfected partners attempt to conceive children. HIV-prevention science can be applied to reduce sexual transmission risk while respecting couples’ reproductive goals. Here we discuss antiretrovirals as prevention in the context of safer conception for HIV-serodiscordant couples. Antiretroviral therapy (ART) for the infected partner and pre-exposure prophylaxis (PrEP) for the uninfected partner reduce the risk of heterosexual HIV transmission. Several demonstration projects suggest the feasibility and acceptability of antiretroviral (ARV)s as periconception HIV-prevention for HIV-serodiscordant couples. The application of ARVs to periconception risk reduction may be limited by adherence. For male-infected (M+F−) couples who cannot access sperm processing and female-infected (F+M−) couples unwilling to carry out insemination without intercourse, ART for the infected partner, PrEP for the uninfected partner, combined with treatment for sexually transmitted infections, sex limited to peak fertility, and medical male circumcision (for F+M couples) provide excellent, well tolerated options for reducing the risk of periconception HIV sexual transmission.