PittsburghV1, France, Analysis, bibRecord, 000440

Oral Antiretroviral Drugs as Public Health Tools for HIV Prevention: Global Implications for Adherence, Drug Resistance, and the Success of HIV Treatment Programs

Identifieur interne : 000440 ( France/Analysis ); précédent : 000439; suivant : 000441

Oral Antiretroviral Drugs as Public Health Tools for HIV Prevention: Global Implications for Adherence, Drug Resistance, and the Success of HIV Treatment Programs

Auteurs : Ravindra K. Gupta [Royaume-Uni] ; Mark A. Wainberg [Canada] ; Francoise Brun-Vezinet [France] ; Jose M. Gatell [Espagne] ; Jan Albert [Suède] ; Anders Sönnerborg [Suède] ; Jean B. Nachega [Afrique du Sud, États-Unis]

Source :

The Journal of infectious diseases [ 0022-1899 ] ; 2013.

RBID : Pascal:13-0228704

Descripteurs français

Pascal (Inist)
- Virus immunodéficience humaine, Antiviral, Antirétroviral, Santé publique, Prévention, Adhérence, Résistance, Traitement, Infection, Pathologie dentaire.
Wicri :
- topic : Santé publique.

English descriptors

KwdEn :
- Adhesion, Antiretroviral agent, Antiviral, Dental disease, Human immunodeficiency virus, Infection, Prevention, Public health, Resistance, Treatment.

Abstract

Recent data from studies on treatment as prevention (TasP) and preexposure prophylaxis (PrEP) show that antiretroviral drugs can be used in prevention, as well as in treatment. The movement from first-generation antiretroviral therapy (ART) coformulations based on thymidine analogues to second-generation ART coformulations based on tenofovir may coincide with future prevention strategies that also use tenofovir/emtricitabine, raising concerns regarding drug resistance. In published studies, failure of prophylaxis was associated with poor adherence and low plasma drug levels. Although rates of drug resistance in cases of failed prevention was low, regular human immunodeficiency virus (HIV) testing was undertaken in these clinical trials. Although legitimate concerns exist about ART adherence and drug resistance associated with PrEP and TasP in real-world settings, efforts to curb the continuing HIV epidemic through use of these novel prevention strategies should move forward because the development and approval of newer drugs reserved for prevention might take many more years. Efforts must be made to monitor ART adherence and to intervene through counseling and other means in order to optimize adherence and retention in care, whenever necessary. Finally, further research involving the generalized epidemic is needed to determine when suboptimal drug use may occur and when regular testing and monitoring of the long-term consequences of ART use may not be routine.

Affiliations:

Links toward previous steps (curation, corpus...)

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to stream Main, to step Exploration: 006A14
to stream France, to step Extraction: 000440

Links to Exploration step

Pascal:13-0228704

Le document en format XML

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<front><div type="abstract" xml:lang="en">Recent data from studies on treatment as prevention (TasP) and preexposure prophylaxis (PrEP) show that antiretroviral drugs can be used in prevention, as well as in treatment. The movement from first-generation antiretroviral therapy (ART) coformulations based on thymidine analogues to second-generation ART coformulations based on tenofovir may coincide with future prevention strategies that also use tenofovir/emtricitabine, raising concerns regarding drug resistance. In published studies, failure of prophylaxis was associated with poor adherence and low plasma drug levels. Although rates of drug resistance in cases of failed prevention was low, regular human immunodeficiency virus (HIV) testing was undertaken in these clinical trials. Although legitimate concerns exist about ART adherence and drug resistance associated with PrEP and TasP in real-world settings, efforts to curb the continuing HIV epidemic through use of these novel prevention strategies should move forward because the development and approval of newer drugs reserved for prevention might take many more years. Efforts must be made to monitor ART adherence and to intervene through counseling and other means in order to optimize adherence and retention in care, whenever necessary. Finally, further research involving the generalized epidemic is needed to determine when suboptimal drug use may occur and when regular testing and monitoring of the long-term consequences of ART use may not be routine.</div>
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Oral Antiretroviral Drugs as Public Health Tools for HIV Prevention: Global Implications for Adherence, Drug Resistance, and the Success of HIV Treatment Programs

Oral Antiretroviral Drugs as Public Health Tools for HIV Prevention: Global Implications for Adherence, Drug Resistance, and the Success of HIV Treatment Programs

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Descripteurs français

English descriptors

Abstract

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