Evidence map›Paper›PMID 30963509›Full record

ReviewDrugs2019

Drug Resistance During HIV Pre-Exposure Prophylaxis.

Kevin M Gibas, Polly van den Berg, Victoria E Powell, Douglas S Krakower

Open access · greenAbstract readReview
In one paragraph

Review in Drugs, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 2 pooled it
6.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed, 2 syntheses or guidelines pooled it, 89 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Kevin M GibasDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA.
Polly van den BergDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA.
Victoria E PowellDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA.
Douglas S KrakowerDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, 110 Francis St. W/LMOB, Suite GB, Boston, MA, 02215, USA. dkrakowe@bidmc.harvard.edu.ORCID http://orcid.org/0000-0003-4027-472X
Beth Israel Deaconess Medical Center · US

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
Harvard University Center for AIDS Research P30 AI060354NIAID NIH HHS P30 AI060354
6 · The paper itself

Abstract

Clinical studies have demonstrated that use of tenofovir disoproxil fumarate with or without emtricitabine as antiretroviral pre-exposure prophylaxis (PrEP) can decrease the risk of human immunodeficiency virus (HIV) acquisition when medication adherence is high. However, the potential for PrEP to promote antiretroviral resistance remains an important public health consideration. We performed a search of the medical literature to identify studies that address HIV drug resistance during PrEP use. In this review, we summarize findings about emergent drug resistance during clinical trials of PrEP, case reports of seroconversions in patients adherent to PrEP, and animal studies of PrEP effectiveness against drug-resistant viral strains. We also discuss the potential utility of novel PrEP formulations for protection against drug-resistant HIV, the impact of drug resistance on HIV treatment options, and mathematical models that estimate the potential contribution of PrEP to population-level drug resistance. Evidence suggests that selection for HIV drug resistance with PrEP use is infrequent and most likely to occur when PrEP is used during undiagnosed acute HIV infection. Breakthrough infections during PrEP use with high adherence are possible, but appear to be rare. The prevalence of drug-resistant HIV strains needs to be monitored as PrEP is scaled up. However, the benefit of a decreased HIV incidence with wider PrEP use is likely to outweigh the risk of harms from possible increases in the prevalence of HIV drug resistance.

Indexed as

AnimalsAnti-HIV AgentsAnti-Retroviral AgentsDrug Resistance, ViralEmtricitabineHIV InfectionsHumansPre-Exposure ProphylaxisTenofovirAnti-HIV AgentsAnti-Retroviral AgentsEmtricitabineTenofovir

Identifiers

PMID30963509
PMCPMC6606557
OpenAlexW2935723645

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.