Drug Delivery and Translational Research

, Volume 7, Issue 6, pp 805–816 | Cite as

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 

Notes

Acknowledgments

The authors would like to acknowledge Zach Demkovich for his help with literature reviews, and reviews of the draft manuscript. We would also like to acknowledge Meredith Clark, Gustavo Doncel, and Marc Baum for the use of figures and information. This research is made possible by the generous support of the American people through the US President’s Emergency Plan for AIDS Relief. The contents are the responsibility of the authors and do not necessarily reflect the views of USAID, PEPFAR, or the US Government. The TFPD program is also sponsored by the Bill and Melinda Gates Foundation. WL is funded by the NSF GRFP.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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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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