The European preexposure prophylaxis revolution

被引:19
作者
Cairns, Gus [1 ,2 ]
McCormack, Sheena [3 ]
Molina, Jean-Michel [4 ,5 ]
机构
[1] NAM Publicat Aidsmap Com, London, England
[2] European AIDS Treatment Grp, Brussels, Belgium
[3] UCL, Inst Clin Trials & Methodol, MRC, Clin Trials Unit, London WC2B 6NH, England
[4] Univ Paris Diderot, INSERM, U941, Sorbonne Paris Cite, Paris, France
[5] Hop St Louis, AP HP, Dept Infect Dis, Paris, France
关键词
Europe; health services; key populations; MSM; preexposure prophylaxis; HIV-INFECTION; ANTIRETROVIRAL PROPHYLAXIS; AFRICAN WOMEN; MEN; SEX; PREVENTION; TENOFOVIR; TRIAL;
D O I
10.1097/COH.0000000000000223
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Purpose of reviewThe review describes the European epidemic and the challenges in moving from clinical trials of preexposure prophylaxis (PrEP) to routine practice.Recent findingsTwo European trials conducted in gay and other MSM and transgender women reported a high and consistent reduction in HIV incidence using oral PrEP with tenofovir/emtricitabine (TDF/FTC). The incidence of HIV infection in the control group was much higher than anticipated, based on routine surveillance data in MSM, in spite of the highest standard of HIV prevention available.SummaryRecent results have highlighted the urgent need to make PrEP available to key populations in Europe as an additional prevention tool. Gilead has not yet submitted an application to use TDF/FTC as PrEP in Europe. Although regulatory approval would accelerate implementation, countries are already dispensing TDF/FTC as postexposure prophylaxis without this. Services for prevention are diverse across countries ranging from free, walk-in services for the diagnosis and treatment of HIV and other sexually transmitted infections, to insurance-dependent reimbursement of private clinical services. Momentum is gathering in Europe with PrEP demonstration projects in MSM and a growing demand from community organizations. Each Member State urgently needs to identify their key populations and determine the service best placed to provide this new prevention strategy within a comprehensive prevention package.
引用
收藏
页码:74 / 79
页数:6
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