Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention.
Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention.
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DOI：
10.1517/14740338.2016.1128412
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发表时间：
2016
影响因子：
3.1
通讯作者：
Baeten JM
中科院分区：
文献类型：
--
作者：
Mugwanya KK;Baeten JM
以富马酸替诺福韦二氧吡酯（TDF）为基础的暴露前预防是一种新的艾滋病毒预防策略，适用于艾滋病毒感染性风险增加的个体。与治疗性干预措施相比，任何生物医学预防干预措施对健康人耐受不良影响的门槛都很高。我们简要总结了基于tdf的暴露前预防的临床安全性，重点介绍了tdf在耐受性和副作用、肾功能、骨密度、HIV抗性、性健康和生殖健康方面的相关影响。本综述的证据基础来自于对随机和观察性研究的文献检索，这些研究评估了基于TDF的PrEP、TDF单独使用或与恩曲他滨联合使用的有效性和安全性，这些研究来自PUBMED和EMBASE电子数据库、clinicaltrials.gov和主要HIV会议。基于tdf的暴露前预防是预防艾滋病毒感染的有效干预措施，通常是安全且耐受性良好的。在人群水平和广泛的个人层面上，PrEP显著降低了HIV感染的风险，从而抵消了与PrEP相关的肾小球滤过率和骨密度的小幅度、非进行性和可逆性下降的风险，以及潜在的耐药性选择。
Tenofovir disoproxil fumarate (TDF)-based pre-exposure prophylaxis is a novel HIV prevention strategy for individuals at increased sexual risk for HIV infection. For any biomedical prevention intervention, the bar for tolerating adverse effects in healthy persons is high compared to therapeutic interventions. We provide a concise summary of the clinical safety of TDF-based pre-exposure prophylaxis with focus on TDF-related effects on tolerability and side effects, kidney function, bone density, HIV resistance, sexual and reproductive health. The evidence base for this review is derived from a literature search of both randomized and observational studies evaluating efficacy and safety of TDF-based PrEP, TDF alone or in combination with emtricitabine, identified from PUBMED and EMBASE electronic databases, clinicaltrials.gov and major HIV conferences. TDF-based pre-exposure prophylaxis is a potent intervention against HIV acquisition when taken which is generally safe and well tolerated. The risk of the small, non-progressive, and reversible decline in glomerular filtration rate and bone mineral density as well as the potential selection for drug resistance associated with PrEP are outweighed, at the population level and broadly for individuals, by PrEP’s substantial reduction in the risk of HIV infection.