HIV Pre-Exposure Prophylaxis in the United States: Impact on Lifetime Infection Risk, Clinical Outcomes and Cost-Effectiveness
February 26, 2009
"The combination of tenofovir and emtricitabine shows promise as HIV pre-exposure prophylaxis (PrEP)," noted the authors, who undertook the current study to forecast the clinical, epidemiological, and economic outcomes of PrEP, "taking into account uncertainties regarding efficacy, the risks of developing drug resistance and toxicity, behavioral disinhibition, and drug costs."
When greater (90 percent) PrEP efficacy was assumed, markedly larger reductions in lifetime infection risk (from 44 percent to 6 percent) were noted. Targeting younger populations with a higher incidence of infection and improvements in the cost and efficacy of PrEP yielded more favorable incremental cost-effectiveness ratios.
"PrEP could substantially reduce the incidence of HIV transmission in populations at high risk of HIV infection in the United States," the authors concluded. "Although it is unlikely to confer sufficient benefits to justify the current costs of tenofovir-emtricitabine, price reductions and/or increases in efficacy could make PrEP a cost-effective option in younger populations or populations at a higher risk of infection. Given recent disappointments in HIV infection prevention and vaccine development, additional study of PrEP-based HIV prevention is warranted."
Clinical Infectious Diseases
03.15.2009; Vol. 48: P. 806-815; A. David Paltiel, Kenneth A. Freedberg, Callie A. Scott, Bruce R. Schackman, Elena Losina, Bingxia Wang, George R. Seage III, Caroline E. Sloan, Paul E. Sax, Rochelle P. Walensky
Intermittent Oral PrEP May Be as Effective as Daily Oral PrEP for Prevention of Rectal HIV Transmission, Macaque Study Suggests
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.