Safety of oral tenofovir disoproxil fumarate-based HIV pre-exposure prophylaxis use in lactating HIV-uninfected women

被引:16
|
作者
Mugwanya, Kenneth K. [1 ,2 ]
John-Stewart, Grace [1 ,3 ,4 ,5 ]
Baeten, Jared [1 ,3 ,5 ]
机构
[1] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA
[2] Makerere Univ, Div Dis Control, Kampala, Uganda
[3] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA
[4] Univ Washington, Dept Pediat, Seattle, WA 98195 USA
[5] Univ Washington, Dept Med, Seattle, WA 98195 USA
关键词
Breastfeeding; pre-exposure prophylaxis; tenofovir disoproxil fumarate; HIV prevention; HIV uninfected women; HIV-1-INFECTED PREGNANT-WOMEN; RANDOMIZED CLINICAL-TRIAL; HEPATITIS-B-VIRUS; ANTIRETROVIRAL PROPHYLAXIS; GROWTH OUTCOMES; DOUBLE-BLIND; PREVENTION; TRANSMISSION; EFFICACY; INFANTS;
D O I
10.1080/14740338.2017.1338271
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: In settings where HIV is prevalent in heterosexual populations, pregnancy and postpartum breastfeeding periods can be associated with substantial HIV acquisition risk. Pre-exposure prophylaxis (PrEP) with daily oral tenofovir disoproxil fumarate (TDF)/emtricitabine is an attractive HIV prevention option for women who are lactating but data are limited on its safety during the lactation period. Areas covered: We provide a concise synthesis and summary of current evidence on the safety of TDF-based PrEP during breastfeeding. We conducted a review, searching Pubmed database and major PrEP conferences for primary studies with TDF-based PrEP exposure during postpartum breastfeeding. Expert opinion: TDF-based oral PrEP is an effective female-controlled HIV prevention option. There is evidence supporting the safety of TDF use for infant outcomes during breastfeeding in antiretroviral treatment regimens for HIV and hepatitis B virus, and more limited, but consistently safe, data from use of TDF as PrEP. The potential for risk is arguably outweighed for at-risk individuals by HIV prevention benefits, including indirect protection to the infant as a result of preventing HIV in the breastfeeding mother. As PrEP delivery is scaled up in heterosexual populations in high HIV prevalence settings and for at-risk persons in other settings, implementation science studies can provide a framework to increase the accrual of safety, acceptability, and use data related to PrEP during lactation.
引用
收藏
页码:867 / 871
页数:5
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