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BMC Medicine
Published in: BMC Medicine 1/2013

Open Access 01-12-2013 | Review

Challenges and opportunities for oral pre-exposure prophylaxis in the prevention of HIV infection: where are we in Europe?

Authors: Jean-Michel Molina, Claire Pintado, Caroline Gatey, Diane Ponscarme, Pierre Charbonneau, Benedicte Loze, Willy Rozenbaum, Constance Delaugerre

Published in: BMC Medicine | Issue 1/2013

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Abstract

Following US Food and Drugs Administration approval in July 2012 of daily oral tenofovir and emtricitabine for pre-exposure prophylaxis (PrEP) to prevent HIV infection in high-risk individuals in the USA, there has been much controversy about the implementation of this PrEP regimen in other countries throughout the world, and in Europe in particular. In this review, we focus on the challenges and opportunities of a daily oral PrEP regimen to curb the rising incidence of HIV infection in high-risk groups, and particularly in men who have sex with men. A number of issues would need to be addressed before PrEP could be implemented, including assessing the real effectiveness and cost-effectiveness of daily PrEP, the sustainability of daily adherence, the risk of selecting resistance, the long-term safety, and the risk of change in sexual behavior that might offset the benefit of PrEP. Alternatives to a daily oral PrEP regimen are being explored.
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Literature
1.
2.
Colbert JA: Clinical decisions. Preexposure prophylaxis for HIV prevention–polling results. N Engl J Med. 2012, 367: e22.CrossRefPubMed
3.
Krakower DS, Mimiaga MJ, Rosenberger JG, et al: Limited awareness and low immediate uptake of pre-exposure prophylaxis among men who have sex with men using an internet social networking site. PLoS One. 2012, 7: e33119.CrossRefPubMedPubMedCentral
4.
Le Vu S, Le Strat Y, Barin F, et al: Population based HIV incidence in France 2003–08: a modelling analysis. Lancet Infect Dis. 2010, 10: 682-687.CrossRefPubMed
5.
Birrel PJ, Gill ON, Delpech VC, et al: HIV incidence in men who have sex with men in England and Wales 2001–2010: nationwide population study. Lancet Infect Dis. 2013, 13: 313-318.CrossRef
6.
Le Vu S, Velter A, Meyer L, et al: Biomarker-based HIV incidence in a community sample of men who have sex with men in Paris. France. PLoS One. 2012, 7: e39872.CrossRefPubMed
7.
Grant RM, Lama JR, Anderson PL, iPrEx Study Team, et al: Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010, 363: 2587-2599.CrossRefPubMedPubMedCentral
8.
9.
Thigpen MC, Kebaabetswe PM, Paxton LA, et al: Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. N Engl J Med. 2012, 367: 423-434.CrossRefPubMed
10.
11.
Marrazzo J, Ramjee G, Nair G, et al: Pre-exposure prophylaxis for HIV in women: daily oral tenofovir, oral tenofovir/emtricitabine or vaginal tenofovir ge in the VOICE study (MTN 003). Presented at the 20th Conference on Retroviruses and Opportunistic Infections. 2013, Atlanta GA, USA: abstract 26LB
12.
Choopanya K, Martin M, Suntharasamai P, et al: Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2013, 381: 2083-2090.CrossRefPubMed
13.
14.
Haire B, Kaldor J, Jordens CFC: How good is “good enough” ? The case for varying standards of evidence according to need for new interventions in HIV prevention. American J Bioethics. 2012, 12: 21-30.CrossRef
15.
Bekker LG, Glidden D, Hosek S, et al: Pre-exposure prophylaxis in young MSM: needs and challenges. Presented at the 20th Conference on Retroviruses and Opportunistic Infections. 2013, Atlanta GA, USA: abstract 997
16.
Patterson KB, Prince HA, Kraft E, et al: Penetration of tenofovir and emtricitabine in mucosal tissues: implication for prevention of HIV-1 transmission. Sci Trans Med. 2011, 3: 112re4.CrossRef
17.
Hughes JP, Baeten JM, Lingappa JR, et al: Determinants of per-coital-act HIV-1 infectivity among African HIV-1-serodiscordant couples. J Infect Dis. 2012, 205: 358-365.CrossRefPubMedPubMedCentral
18.
Mlisana K, Naicker N, Werner L, et al: Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa. J Infect Dis. 2012, 206: 6-14.CrossRefPubMedPubMedCentral
19.
Liu AY, Vittinghoff E, Sellmeyer DE, et al: Bone mineral density in HIV-negative men participating in a tenofovir pre-exposure prophylaxis randomized clinical trial in San Francisco. PLoS One. 2011, 6: e23688.CrossRefPubMedPubMedCentral
20.
Pavie J, Rachline A, Loze B, et al: Sensitivity of five rapid HIV tests on oral fluid or finger-stick whole blood: a real-time comparison in a healthcare setting. PLoS One. 2010, 5: e11581.CrossRefPubMedPubMedCentral
21.
Juusola JL, Brandeau ML, Owens DK, Bendavid E: The cost-effectiveness of preexposure prophylaxis for HIV prevention in the United States in men who have sex with men. Ann Intern Med. 2012, 156: 541-550.CrossRefPubMedPubMedCentral
22.
Gomez GB, Borquez A, Caceres CF, et al: The potential impact of pre-exposure prophylaxis for HIV prevention among men who have sex with men and transgender women in Lima. Peru: a mathematical modelling study. PLoS Med. 2012, 9: e1001323.CrossRefPubMedPubMedCentral
23.
24.
Ware NC, Wyatt MA, Haberer JE, et al: What’s love got to do with it? Explaining adherence to oral antiretroviral pre-exposure prophylaxis for HIV-serodiscordant couples. J Acquir Immune Defic Syndr. 2012, 59: 463-468.CrossRefPubMed
25.
Hosek SG, Siberry G, Bell M, et al: The acceptability and feasibility of an HIV preexposure prophylaxis trial with young men who have sex with men. J Acquir Immune Defic Syndr. 2013, 62: 447-456.CrossRefPubMed
26.
Grant R, McMahan V, Amico R, et al: Drug detection during open-label extension of the iPrEx trial indicates sustained and appropriate interest in PrEP among men who have sex with men. Presented at the 7th IAS Conference on HIV Pathogenesis treatment and Prevention. 2013, Kuala Lumpur Malaysia: Abstract WELBC02
27.
Castillo-Mancilla JR, Zheng JH, Rower JE, et al: Tenofovir, emtricitabine, and tenofovir diphosphate in dried blood spots for determining recent and cumulative drug exposure. AIDS Res Hum Retroviruses. 2013, 29: 384-390.PubMedPubMedCentral
28.
Shah SA, Mullin R, Jones G, et al: Simultaneous analysis of antiretroviral drugs abacavir and tenofovir in human hair by liquid chromatography-tandem mass spectrometry. J Pharm Biomed Anal. 2013, 74: 308-313.CrossRefPubMed
29.
García-Lerma JG, Cong ME, Mitchell J, et al: Intermittent prophylaxis with oral Truvada protects macaques from rectal SHIV infection. Sci Transl Med. 2010, 2: 14ra4.CrossRefPubMed
30.
31.
32.
Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al: Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010, 329: 1168-1174.CrossRefPubMedPubMedCentral
33.
Lorente N, Fugon L, Carrieri MP, et al: Acceptability of an “on demand” pre-exposure HIV prophylaxis trial among men who have sex with men living in France. AIDS Care. 2012, 24: 468-477.PubMed
34.
Volk JE, Liu A, Vittinghoff E, et al: Sexual frequency and planning among at-risk men who have sex with men in the United States: implications for event-based intermittent pre-exposure prophylaxis. J Acquir Immune Defic Syndr. 2012, 61: 112-115.CrossRefPubMedPubMedCentral
35.
Hosek S, Telander K, Balthazar C, et al: Does sexual behaviour influence adherence to pre-exposure prohylaxis? Data from a pre-exposure prophylaxis trial among young MSM. Presented at the 20th Conference on Retroviruses and Opportunistic Infections. 2013, Atlanta GA, USA: abstract 996
36.
Anderson PL, Glidden DV, Liu A, et al: Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Sci Transl Med. 2012, 151: 151ra125.
37.
Van’T Klooster G, Hoeben E, Borghys H, et al: Pharmacokinetics and disposition of rilpivirine (TMC278) nanosuspension as a long-acting injectable antiretroviral formulation. Antimicrob Agents Chemother. Antimicrob Agents Chemother. 2010, 54: 2042-2050.CrossRef
38.
Andrews C, Gettie A, Russel-Lodrigue K, et al: Long-acting parenteral formulation of GSK1265744 protects macaques against repeated intrarectal challenges with SHIV. Presented at the 20th Conference on Retroviruses and Opportunistic Infections. 2013, Atlanta GA, USA: abstract 24LB
39.
McCormack S, Fidler S, Fisher M: The British HIV Association/British Association for Sexual Health and HIV Position Statement on pre-exposure prophylaxis in the UK- International. J STD Aids. 2012, 23: 1-4.CrossRef
Metadata
Title
Challenges and opportunities for oral pre-exposure prophylaxis in the prevention of HIV infection: where are we in Europe?
Authors
Jean-Michel Molina
Claire Pintado
Caroline Gatey
Diane Ponscarme
Pierre Charbonneau
Benedicte Loze
Willy Rozenbaum
Constance Delaugerre
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2013
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-11-186

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