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Clin Investig (Lond). 2013 Mar;3(3). doi: 10.4155/cli.12.155.

HIV PrEP Trials: The Road to Success.

Author information

1
Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Kerr Hall 3317, CB#7569, Chapel Hill, NC 27519-7569, (P) 919-843-0321, (F) 919-962-0644.
2
Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, 600 South 43rd Street, Philadelphia, PA 19104-4495, (P) 215-596-8759.
3
Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Kerr Hall 3318, CB#7569, Chapel Hill, NC 27519-7569, (P) 919-966-9998, (F) 919-962-0644.

Abstract

The global HIV epidemic cannot be controlled by current treatment or prevention strategies. Pre-exposure prophylaxis (PrEP) using antiretrovirals is a promising approach to curbing the spread of HIV transmission. Recently, four clinical trials demonstrated favorable results when antiretroviral PrEP was administered topically or orally. However, two additional trials were unable to demonstrate a benefit, indicating that further study is required to define the populations and conditions under which PrEP will be effective. Adherence is highly correlated with protection, yet the exact level of adherence required is unknown. Future studies may require increased drug exposure testing and more objective methods to monitor adherence in real-time. Although the development of drug resistance in the PrEP trials has been low, it remains a concern, as therapeutic options could be compromised for those who seroconvert while on PrEP.

KEYWORDS:

HIV; adherence; prevention; prophylaxis; tenofovir

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