Abstract
Intervention Préventive de l’Exposition aux Risques avec et pour les Gays (iPERGAY), a double-blind randomized controlled trial (RCT)[5] conducted in France and Canada, found that the risk of HIV infection in MSM populations who took tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) on demand was 86% lower than that in the placebo group. A systematic review and meta-analysis of 18 international observational studies including RCTs comprising different key populations showed that PrEP regimens that included TDF (mainly TDF/FTC) reduced the risk of HIV infection. [4,24–26] PrEP with drugs other than TDF/FTC The results of the DISCOVER study—a double-blind phase III RCT evaluating the effectiveness and safety of tenofovir alafenamide (TAF)/FTC PrEP in MSM—showed that the risk of HIV infection was reduced by 98% and 89% with TAF/FTC and TDF/FTC, respectively, compared to the control; the two-drug combinations were similarly effective according to the non-inferiority analysis, and no FTC or TAF resistance was observed among seroconverts in the two treatment groups. Additionally, in an RCT (HIV Prevention Trials Network 083)[30] of long-acting (LA) injectables for PrEP that enrolled 4570 subjects in several countries who engaged in high-risk behaviors, the risk of new HIV infection was lower in cabotegravir (CAB) taken every 8 weeks than in daily TDF/FTC injection group (incidence rate 0.38% vs. 1.21%; hazard ratio: 0.31, 95% CI: 0.16–0.59).
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1 National Health Commission (NHC) Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China; Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China; Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, Liaoning 110001, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
2 Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
3 Department of Infection, Peking Union Medical College Hospital, Beijing 100730, China
4 Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
5 Chongqing Public Health Medical Center, Chongqing 400036, China
6 Department of Infectious Diseases, National Clinical Center for Infectious Diseases, Third People's Hospital of Shenzhen (Second Affiliated Hospital of Southern University of Science and Technology), Shenzhen, Guangdong 518112, China
7 National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
8 Shenzhen Rainbow 258 Centre For Men, Shenzhen, Guangdong 518001, China