Efficacy of HIV postexposure prophylaxis: systematic review and meta-analysis of nonhuman primate studies

Cadi Irvine, Kieren J. Egan, Zara Shubber, Koen K.A. Van Rompay, Rachel L. Beanland, Nathan Ford

Research output: Contribution to journalReview article

26 Citations (Scopus)

Abstract

Background. The efficacy of antiretrovirals as postexposure prophylaxis (PEP) to prevent viral acquisition was demonstrated in nonhuman primate models of human immunodeficiency virus (HIV) in the early 1990s. To complement the evidence base for efficacy of HIV PEP in humans, we systematically reviewed the published data on PEP efficacy across animal studies. Methods. PubMed, Web of Science, and Embase were searched from inception to 31 May 2014 for randomized and nonrandomized studies reporting seroconversions among uninfected animals exposed to HIV or simian immunodeficiency virus, irrespective of route of exposure. Seroconversion risk data were pooled using random-effects models, and associations explored through meta-regression. Results. Twenty-five studies (408 primates) were included for review. The risk of serconversion was 89% lower among animals exposed to PEP compared with those that did not receive PEP (odds ratio, 0.11 [95% confidence interval, .05-.23]). Heterogeneity was low (I2 = 0.0%). In meta-regression, a significant association was found between timing of PEP and seroconversion and the use of tenofovir compared with other drugs. Conclusions. This review provides further evidence of the protective benefit of PEP in preventing HIV acquisition, and the importance of initiating PEP as early as possible following virus exposure.

LanguageEnglish
PagesS165-S169
Number of pages5
JournalClinical Infectious Diseases
Volume60
Issue numberSuppl 3
DOIs
Publication statusPublished - 11 May 2015

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Primates
Meta-Analysis
HIV
Tenofovir
Simian Immunodeficiency Virus
PubMed
Odds Ratio
Confidence Intervals
Viruses
Pharmaceutical Preparations
Seroconversion

Keywords

  • HIV/AIDS
  • nonhuman primate
  • postexposure prophylaxis
  • transmission

Cite this

Irvine, Cadi ; Egan, Kieren J. ; Shubber, Zara ; Van Rompay, Koen K.A. ; Beanland, Rachel L. ; Ford, Nathan. / Efficacy of HIV postexposure prophylaxis : systematic review and meta-analysis of nonhuman primate studies. In: Clinical Infectious Diseases. 2015 ; Vol. 60, No. Suppl 3. pp. S165-S169.
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abstract = "Background. The efficacy of antiretrovirals as postexposure prophylaxis (PEP) to prevent viral acquisition was demonstrated in nonhuman primate models of human immunodeficiency virus (HIV) in the early 1990s. To complement the evidence base for efficacy of HIV PEP in humans, we systematically reviewed the published data on PEP efficacy across animal studies. Methods. PubMed, Web of Science, and Embase were searched from inception to 31 May 2014 for randomized and nonrandomized studies reporting seroconversions among uninfected animals exposed to HIV or simian immunodeficiency virus, irrespective of route of exposure. Seroconversion risk data were pooled using random-effects models, and associations explored through meta-regression. Results. Twenty-five studies (408 primates) were included for review. The risk of serconversion was 89{\%} lower among animals exposed to PEP compared with those that did not receive PEP (odds ratio, 0.11 [95{\%} confidence interval, .05-.23]). Heterogeneity was low (I2 = 0.0{\%}). In meta-regression, a significant association was found between timing of PEP and seroconversion and the use of tenofovir compared with other drugs. Conclusions. This review provides further evidence of the protective benefit of PEP in preventing HIV acquisition, and the importance of initiating PEP as early as possible following virus exposure.",
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Efficacy of HIV postexposure prophylaxis : systematic review and meta-analysis of nonhuman primate studies. / Irvine, Cadi; Egan, Kieren J.; Shubber, Zara; Van Rompay, Koen K.A.; Beanland, Rachel L.; Ford, Nathan.

In: Clinical Infectious Diseases, Vol. 60, No. Suppl 3, 11.05.2015, p. S165-S169.

Research output: Contribution to journalReview article

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