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HIV Pre-Exposure Prophylaxis: New and Upcoming Drugs to Address the HIV Epidemic

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Abstract

Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) provides a critical intervention toward ending the HIV epidemic and protecting people with reasons to utilize PrEP. PrEP options continue to expand as new administration modalities offer the potential to tailor PrEP use for individual success. We have provided the evidence for new and emerging antiretroviral agents for PrEP (cabotegravir, lenacapavir, dapivirine, and broadly neutralizing antibodies), divided into pharmacology, animal model, and human data, accompanied by a summary and suggested place in therapy. Cabotegravir is a US Food and Drug Administration (FDA)-approved intramuscular injection given every 2 months with a strong body of evidence demonstrating efficacy for HIV PrEP, lenacapavir administered subcutaneously every 6 months is currently under investigation for HIV PrEP, dapivirine vaginal ring is an available PrEP option for women in certain areas of Africa, and broadly neutralizing monoclonal antibodies have been challenged in demonstrating efficacy in phase 1–2 study for HIV PrEP to date. Clinical literature for individual agents is discussed with data from major studies summarized in tables. This review provides a detailed overview of recently available and premier candidate PrEP drugs.

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Authors and Affiliations

  1. Section of Infectious Diseases, HIV Program, Mayo Clinic, Rochester, MN, USA

    Christina G. Rivera, John D. Zeuli, Tanner M. Johnson & Zelalem Temesgen

  2. Department of Pharmacy, Mayo Clinic, Rochester, MN, USA

    Christina G. Rivera, John D. Zeuli, Tanner M. Johnson & Ashley O. Otto

  3. Department of Pharmacy, Grady Health System, Atlanta, GA, USA

    Bradley L. Smith

  4. Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, USA

    Ramona Bhatia

  5. Section of Infectious Diseases, Mayo Clinic and Foundation, 200 First St. SW, Rochester, MN, 55905, USA

    Zelalem Temesgen

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  1. Christina G. Rivera
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Correspondence to Zelalem Temesgen.

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All authors contributed equally to this manuscript, read, and approved the final version.

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C.G.R. and B.L.S. have served on advisory board for Gilead Sciences, Inc., J.D.Z. has served on advisory boards for ViiV healthcare, Thera Technologies, and R.B. serves as advisory to the CDC on PrEP for the President’s Emergency Plan for AIDS Relief (PEPFAR) program.

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Rivera, C.G., Zeuli, J.D., Smith, B.L. et al. HIV Pre-Exposure Prophylaxis: New and Upcoming Drugs to Address the HIV Epidemic. Drugs 83, 1677–1698 (2023). https://doi.org/10.1007/s40265-023-01963-9

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