Evolving uses of oral reverse transcriptase inhibitors in the HIV-1 epidemic: from treatment to prevention.
Evolving uses of oral reverse transcriptase inhibitors in the HIV-1 epidemic: from treatment to prevention.
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DOI：
10.1186/1742-4690-10-82
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发表时间：
2013-07-31
期刊：
影响因子：
3.3
通讯作者：
Wainberg MA
中科院分区：
文献类型：
--
作者：
Gupta RK;Van de Vijver DA;Manicklal S;Wainberg MA
艾滋病毒疫情继续有增无减，没有高效疫苗，也没有治愈方法。每一个新的感染都有巨大的经济、社会和人力成本，预防工作现在与全球抗逆转录病毒疗法的推广一样重要。逆转录酶抑制剂是第一类获得许可的抗逆转录病毒疗法，在过去二十年中一直处于治疗和预防母婴传播的最前沿。现在，它们在成人预防中的使用正在被广泛研究。我们描述两种方法：治疗即预防（TasP）-在艾滋病毒诊断后使用联合ART（2NRTI和1 NNRTI）以限制传播和暴露前预防（PrEP）-在性接触前使用单一或双重口服药物。使用NRTI预防母婴传播非常成功，但并不涉及持续使用NRTI来限制传播。尽管TasP和PrEP有理论和初步支持，但迄今为止的数据表明，依从性、保留护理和晚期诊断是其成功、持续实施的主要障碍。药物技术的未来发展将需要克服药物依从性的问题，通过开发涉及更少频率给药以及降低毒性的药物，可能通过特异性靶向感染细胞。
The HIV epidemic continues unabated, with no highly effective vaccine and no cure. Each new infection has significant economic, social and human costs and prevention efforts are now as great a priority as global antiretroviral therapy (ART) scale up. Reverse transcriptase inhibitors, the first licensed class of ART, have been at the forefront of treatment and prevention of mother to child transmission over the past two decades. Now, their use in adult prevention is being extensively investigated. We describe two approaches: treatment as prevention (TasP) - the use of combination ART (2NRTI and 1NNRTI) following HIV diagnosis to limit transmission and pre-exposure prophylaxis (PrEP) –the use of single or dual oral agents prior to sexual exposure. Prevention of mother-to-child transmission using NRTI has been highly successful, though does not involve sustained use of NRTI to limit transmission. Despite theoretical and preliminary support for TasP and PrEP, data thus far indicate that adherence, retention in care and late diagnosis are the major barriers to their successful, sustained implementation. Future advances in drug technologies will be needed to overcome the issue of drug adherence, through development of drugs that involve both less frequent dosing as well as reduced toxicity, possibly through specific targeting of infected cells.
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DOI：
10.1056/nejmoa0911486
发表时间：
2010-06-17
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chasela CS;Hudgens MG;Jamieson DJ;Kayira D;Hosseinipour MC;Kourtis AP;Martinson F;Tegha G;Knight RJ;Ahmed YI;Kamwendo DD;Hoffman IF;Ellington SR;Kacheche Z;Soko A;Wiener JB;Fiscus SA;Kazembe P;Mofolo IA;Chigwenembe M;Sichali DS;van der Horst CM;BAN Study Group
通讯作者：
BAN Study Group
影响因子：
120.7
作者：
Coovadia, Ashraf;Abrams, Elaine J.;Kuhn, Louise
通讯作者：
Kuhn, Louise
影响因子：
6.4
作者：
Abbas, Ume L.;Glaubius, Robert;Mellors, John W.
通讯作者：
Mellors, John W.
DOI：
10.1097/00126334-200204150-00009
发表时间：
2002-04-15
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cooper, ER;Charurat, M;Blattner, W
通讯作者：
Blattner, W
影响因子：
11.8
作者：
Bennett, Diane E.;Jordan, Michael R.;Kelley, Karen F.
通讯作者：
Kelley, Karen F.