Efficacy and safety of long‐acting cabotegravir versus oral tenofovir disoproxil fumarate‐emtricitabine as HIV pre‐exposure prophylaxis: A systematic review and meta‐analysis

恩曲他滨 替诺福韦 暴露前预防 医学 荟萃分析 人类免疫缺陷病毒(HIV) 药理学 内科学 重症监护医学 病毒学 抗逆转录病毒疗法 病毒载量 梅毒 和男人发生性关系的男人
作者
Chen Xiu,Jun Li,Liqiu Kou,Xiaolu Xie,Dafu Wei,Yaling Li
出处
期刊:Reviews in Medical Virology [Wiley]
卷期号:33 (4) 被引量:1
标识
DOI:10.1002/rmv.2460
摘要

WHO guidelines recommend daily oral tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) for pre-exposure prophylaxis (PrEP) of HIV in people at high risk of HIV infection. However, due to social, psychological and other reasons, the compliance with daily oral TDF-FTC in real life is low. Long-acting cabotegravir is currently the only long-acting drug approved by the U.S. Food and Drug Administration (FDA) for HIV PrEP. Due to the long dosing interval (8 weeks), long-acting cabotegravir has low compliance requirements for people at high risk of HIV infection. We aimed to discuss the feasibility of long-acting cabotegravir to replace TDF-FTC as HIV PrEP based on efficacy and safety analyses. Randomized controlled trials were retrieved, and R software was used for meta-analysis after data extraction. and discussion: Results of the meta-analysis showed that compared with TDF-FTC, long-acting cabotegravir was associated with a lower risk of HIV infection (HR = 0.22, 95% CI: 0.08-0.59, p < 0.01), less decreased creatinine clearance (RR = 0.96, 95% CI: 0.93-0.99, p < 0.01), but more tolerated injection sites adverse events (p < 0.01). No statistically significant differences were found between long-acting cabotegravir and oral placebo in non-injection-related adverse events (creatine phosphokinase, headache, nasopharyngitis, upper respiratory tract infection and gastroenteritis) (p > 0.05). Long-acting cabotegravir has a manageable safety profile and is more effective than TDF-FTC in preventing HIV infection. Interestingly, decreased creatinine clearance occurred less frequently with long-acting cabotegravir than with TDF-FTC. Long-acting cabotegravir is very promising to replace TDF-TFC in the future, which requires more large-sample, high-quality RCTs to verify.
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