Potential of Long-Acting Products to Transform the Treatment and Prevention of Human Immunodeficiency Virus (HIV) in Infants, Children, and Adolescents
Potential of Long-Acting Products to Transform the Treatment and Prevention of Human Immunodeficiency Virus (HIV) in Infants, Children, and Adolescents
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DOI：
10.1093/cid/ciac754
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发表时间：
2022-11-21
影响因子：
11.8
通讯作者：
Mirochnick，Mark
中科院分区：
文献类型：
--
作者：
Abrams，Elaine J.;Capparelli，Edmund;Mirochnick，Mark
长效抗逆转录病毒产品有可能改变儿童人群中人类免疫缺陷病毒(艾滋病毒)的预防和治疗方法。通过注射的广泛中和抗体和/或长效抗逆转录病毒制剂可以极大地改善向有艾滋病毒感染风险的新生儿和婴儿提供艾滋病毒预防和/或早期治疗。使用长效制剂可以缓解幼儿和携带艾滋病毒的学龄儿童每天口服抗逆转录病毒药物的挑战，但在进入常规临床使用之前，必须研究这些产品在儿童中的药代动力学和安全性。虽然对婴幼儿的广谱中和抗体和可注射长效剂的一些初步研究正在进行中，但还需要对这些和其他长效产品进行更多的研究。对于许多青少年来说，遵守日常用药尤其具有挑战性。长效产品对感染艾滋病毒的青少年以及感染艾滋病毒的高危人群具有特别的前景，青少年通常可以与成年人同时被纳入药物开发流程。长效产品有可能为整个儿科年龄段的终身每日口服药物提供替代方案，从而更有效地预防和治疗婴儿、儿童和青少年中的艾滋病毒感染。
Long-acting antiretroviral products have the potential to transform human immunodeficiency virus (HIV) prevention and treatment approaches in pediatric populations. Broadly neutralizing antibodies and/or long-acting antiretroviral formulations by injection could dramatically improve provision of HIV prophylaxis and/or early treatment to newborns and infants at risk of HIV infection. Challenges in daily oral antiretroviral administration to toddlers and school age children living with HIV may be relieved by use of long-acting formulations, but the pharmacokinetics and safety of these products in children must be studied before they can enter routine clinical use. Although some initial studies of broadly neutralizing antibodies and injectable long-acting agents in infants and young children are underway, more studies of these and other long-acting products are needed. For many adolescents, compliance with daily medication administration is especially challenging. Long-acting products hold particular promise for adolescents living with HIV as well as those at high risk of HIV acquisition, and adolescents can usually be included in the drug development pipeline simultaneously with adults. Long-acting products have the potential to provide alternatives to lifelong daily oral drug administration across the pediatric age spectrum, leading to more effective prevention and treatment of HIV infection in infants, children, and adolescents.