Pre-exposure prophylaxis against HIV infection: Which drugs should be tested?
Giving anti-HIV drugs to HIV-negative people who are at high risk of HIV infection (pre-exposure prophylaxis or "PREP") may become an important tool in curbing the HIV pandemic, says a group of researchers in a policy paper in PLoS Medicine.
Inge Derdelinckx (University Medical Center, Utrecht) and colleagues formulate criteria for what would be the optimal drug to test as a PREP candidate in clinical trials. They then evaluate existing antiviral drugs to see which of these would best fit these criteria.
Based on their analysis, they conclude that lamivudine (3TC) would be a good PREP candidate to test, "given its relative safety, ease of use, mode of action and pharmacology, antiviral profile, and cost-effectiveness." Whether its use would be optimal as monotherapy or in combination with another antiviral, they say, is still unknown.
"Randomised clinical trials to evaluate 3TC's efficacy in preventing new HIV infections are the only way forward," say the authors.
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Citation: Derdelinckx I, Wainberg MA, Lange JMA, Hill A, Halima Y, et al. (2006) Criteria for drugs used in pre-exposure prophylaxis trials against HIV infection. PLoS Med 3(11): e454.
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