Long acting systemic HIV pre-exposure prophylaxis: an examination of the field

  • William R. Lykins
  • Ellen Luecke
  • Daniel Johengen
  • Ariane van der Straten
  • Tejal A. Desai
Review Article

Abstract

Oral pre-exposure prophylaxis for the prevention of HIV-1 transmission (HIV PrEP) has been widely successful as demonstrated by a number of clinical trials. However, studies have also demonstrated the need for patients to tightly adhere to oral dosing regimens in order to maintain protective plasma and tissue concentrations. This is especially true for women, who experience less forgiveness from dose skipping than men in clinical trials of HIV PrEP. There is increasing interest in long-acting (LA), user-independent forms of HIV PrEP that could overcome this adherence challenge. These technologies have taken multiple forms including LA injectables and implantables. Phase III efficacy trials are ongoing for a LA injectable candidate for HIV PrEP. This review will focus on the design considerations for both LA injectable and implantable platforms for HIV PrEP. Additionally, we have summarized the existing LA technologies currently in clinical and pre-clinical studies for HIV PrEP as well as other technologies that have been applied to HIV PrEP and contraceptives. Our discussion will focus on the potential application of these technologies in low resource areas, and their use in global women’s health.

Keywords

HIV prevention Pre-exposure prophylaxis Antiretroviral Chemo prophylaxis Long acting 

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Copyright information

© Controlled Release Society 2017

Authors and Affiliations

  • William R. Lykins
    • 1
    • 2
  • Ellen Luecke
    • 3
  • Daniel Johengen
    • 2
  • Ariane van der Straten
    • 2
    • 4
  • Tejal A. Desai
    • 1
    • 2
  1. 1.UC Berkeley-UCSF Graduate Program in BioengineeringSan Francisco and BerkeleyUSA
  2. 2.Department of Bioengineering and Therapeutic SciencesUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Women’s Global Health ImperativeRTI InternationalSan FranciscoUSA
  4. 4.Center for AIDS Prevention Studies, Department of MedicineUniversity of California San FranciscoSan FranciscoUSA

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