The European preexposure prophylaxis revolution
Identifieur interne : 000002 ( France/Analysis ); précédent : 000001; suivant : 000003The European preexposure prophylaxis revolution
Auteurs : Gus Cairns [Royaume-Uni, Belgique] ; Sheena Mccormack [Royaume-Uni] ; Jean-Michel Molina [France]Source :
- Current Opinion in HIV and AIDS [ 1746-630X ] ; 2016.
Abstract
The review describes the European epidemic and the challenges in moving from clinical trials of preexposure prophylaxis (PrEP) to routine practice.
Two 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.
Recent 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.
Url:
DOI: 10.1097/COH.0000000000000223
PubMed: 26599164
PubMed Central: 4888928
Affiliations:
- Belgique, France, Royaume-Uni
- Angleterre, Grand Londres, Région de Bruxelles-Capitale
- Bruxelles, Londres, Paris
- University College de Londres
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PMC:4888928Le document en format XML
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<series><title level="j">Current Opinion in HIV and AIDS</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose of review</title>
<p>The review describes the European epidemic and the challenges in moving from clinical trials of preexposure prophylaxis (PrEP) to routine practice.</p>
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<sec><title>Recent findings</title>
<p>Two 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.</p>
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<sec sec-type="summary"><title>Summary</title>
<p>Recent 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.</p>
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