暴露前预防（PrEP）与治疗即预防（TasP）控制HIV：平衡点在哪里？
Pre-exposure prophylaxis (PrEP) versus treatment-as-prevention (TasP) for the control of HIV: Where does the balance lie?
摘要：
抗逆转录病毒药物可以将艾滋病毒感染者的传染性降低约96%-作为预防或TasP的治疗-并且可以将艾滋病毒阳性者感染的风险降低约70%-暴露前预防或PrEP-提高了使用抗逆转录病毒药物阻止艾滋病毒流行的前景。科学文献中仍在讨论哪种方法更有效、更负担得起和更具成本效益，以及在何种条件下更有效。在这里，我们比较了TasP和PreP，以确定每种策略的有利条件。这项分析表明，当艾滋病毒的发病率低于5%或PrEP下的风险降低低于50%时，TasP优于PrEP;否则PrEP优于TasP。因此，使用PreP的可能性应仅限于艾滋病毒年发病率大于5%的人群，TasP可减少50%以上的传播。PreP应考虑用于商业性工作者、20至25岁的年轻女性、男男性行为者或静脉注射毒品者，但仅限于艾滋病毒发病率高的地方。
英文摘要：
Anti-retroviral drugs can reduce the infectiousness of people living with HIV by about 96%--treatment as prevention or TasP--and can reduce the risk of being infected by an HIV positive person by about 70%--pre-exposure prophylaxis or PrEP--raising the prospect of using anti-retroviral drugs to stop the epidemic of HIV. The question as to which is more effective, more affordable and more cost effective, and under what conditions, continues to be debated in the scientific literature. Here we compare TasP and PreP in order to determine the conditions under which each strategy is favourable. This analysis suggests that where the incidence of HIV is less than 5% or the risk-reduction under PrEP is less than 50%, TasP is favoured over PrEP; otherwise PrEP is favoured over TasP. The potential for using PreP should therefore be restricted to those among whom the annual incidence of HIV is greater than 5% and TasP reduces transmission by more than 50%. PreP should be considered for commercial sex workers, young women aged about 20 to 25 years, men-who-have-sex with men, or intravenous drug users, but only where the incidence of HIV is high.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
