希望、危险和谨慎乐观:治疗和预防艾滋病毒长效模式的下一个前沿。

IF 4.5 3区 医学 Q2 IMMUNOLOGY
Morgan M Philbin, Amaya Perez-Brumer
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引用次数: 7

摘要

综述目的:本文综述了人类免疫缺陷病毒(HIV)治疗和预防的长效(LA)模式的最新治疗进展。近期发现:LA注射抗逆转录病毒疗法(ART)已在美国、加拿大和欧洲获得批准;美国也批准了LA注射暴露前预防(PrEP),世界卫生组织推荐阴道PrEP环。目前临床试验中的LA PrEP方式包括注射、膜、环和植入;试验中的LA ART治疗方式包括皮下注射和长期口服药丸。尽管洛杉矶模式具有令人难以置信的前景,但全球可用性受到长期存在的多层次风险的抑制,包括多边资金减少、专利保护和缺乏政治意愿。一旦有了,获取和利用就会受到保险覆盖、诊所准入、劳动力市场、污名化以及结构性种族主义和性别歧视等因素的限制。必须解决这些问题,以促进所有人公平获得机会。摘要:最近在抗逆转录病毒治疗和预防方法的功效方面取得了巨大进展,重新燃起了“终结艾滋病毒流行”的希望。然而,普遍存在的社会结构不平等限制了洛杉矶模式的前景,强调了在研究、开发和人口层面实施的轨迹中存在不平等的谨慎乐观的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV.

Promise, perils and cautious optimism: the next frontier in long-acting modalities for the treatment and prevention of HIV.

Purpose of review: This paper provides a critical review of recent therapeutic advances in long-acting (LA) modalities for human immunodeficiency virus (HIV) treatment and prevention.

Recent findings: LA injectable antiretroviral therapy (ART) has been approved in the United States, Canada and Europe; the United States also has approved LA injectable preexposure prophylaxis (PrEP) and the World Health Organization has recommended the vaginal PrEP ring. Current LA PrEP modalities in clinical trials include injections, films, rings, and implants; LA ART modalities in trials include subcutaneous injections and long-term oral pills. Although LA modalities hold incredible promise, global availability is inhibited by long-standing multilevel perils including declining multilateral funding, patent protections and lack of political will. Once available, access and uptake are limited by factors such as insurance coverage, clinic access, labor markets, stigma, and structural racism and sexism. These must be addressed to facilitate equitable access for all.

Summary: There have been tremendous recent advances in the efficacy of LA ART and PrEP modalities, providing renewed hope that 'ending the HIV epidemic' is within reach. However, pervasive socio-structural inequities limit the promise of LA modalities, highlighting the need for cautious optimism in light of the embedded inequities in the trajectory of research, development, and population-level implementation.

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来源期刊
Current Opinion in HIV and AIDS
Current Opinion in HIV and AIDS IMMUNOLOGY-INFECTIOUS DISEASES
CiteScore
7.40
自引率
7.30%
发文量
115
审稿时长
6-12 weeks
期刊介绍: Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in HIV and AIDS features hand-picked review articles from our team of expert editors. With six disciplines published across the year – including HIV and ageing, a HIV vaccine, and epidemiology – every issue also contains annotated reference detailing the merits of the most important papers.
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