Risks and benefits of oral HIV pre-exposure prophylaxis for people with chronic hepatitis B

被引：6

作者：

Mohareb, Amir M. ^{[1
,2
,4
]}

Larmarange, Joseph ^{[5
]}

Kim, Arthur Y. ^{[2
,4
]}

Coffie, Patrick A. ^{[6
,7
]}

Kouame, Menan Gerard ^{[7
]}

Boyd, Anders ^{[8
,9
]}

Freedberg, Kenneth A. ^{[1
,2
,3
,4
]}

Hyle, Emily P. ^{[1
,2
,4
]}

机构：

[1] Massachusetts Gen Hosp, Med Practice Evaluat Ctr, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Div Infect Dis, Boston, MA 02114 USA

[3] Massachusetts Gen Hosp, Div Gen Internal Med, Boston, MA 02114 USA

[4] Harvard Med Sch, Dept Med, Boston, MA 02115 USA

[5] Univ Paris Cite, Ctr Populat & Dev, INSERM, IRD, Paris, France

[6] Univ Felix Houphouet Boigny, Dept Dermatol & Infectiol, Abidjan, Cote Ivoire

[7] Programme PAC CI, Abidjan, Cote Ivoire

[8] Stichting Hiv Monitoring, Amsterdam, Netherlands

[9] Publ Hlth Serv Amsterdam, Dept Infect Dis, Amsterdam, Netherlands

来源：

LANCET HIV | 2022年 / 9卷 / 08期

基金：

美国国家卫生研究院;

关键词：

TENOFOVIR DISOPROXIL FUMARATE; HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIRETROVIRAL PROPHYLAXIS; ALANINE AMINOTRANSFERASE; SEX WORKERS; INFECTION; MORTALITY; THERAPY; MEN; PATIENT;

D O I：

10.1016/S2352-3018(22)00123-0

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Individuals with chronic hepatitis B virus (HBV) infection who are at substantial risk of HIV acquisition benefit from pre-exposure prophylaxis (PrEP) with tenofovir-based antiviral therapy. Considering that tenofovir potently inhibits HBV, providing PrEP to individuals with HBV effectively results in treatment of their HBV infection. However, some clinicians might be hesitant to initiate PrEP in people with chronic HBV due to unknown risks of HBV reactivation, hepatitis, and acute liver failure during periods of antiviral cessation. Unfortunately, these knowledge gaps affect scale up of PrEP among people with chronic HBV. Emerging data regarding the risks and benefits of antiviral cessation in people with chronic HBV suggest that PrEP can be safely initiated despite the risks of non-adherence or discontinuation. People with chronic HBV who stop PrEP should be closely monitored for HBV reactivation and hepatitis flares after antiviral cessation.

引用

页码：E585 / E594

页数：10

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