Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.

<h4>Background</h4>Nearly ten randomized controlled trials (RCTs) of pre-exposure prophylaxis (PrEP) have been completed or are ongoing worldwide to evaluate the effectiveness of PrEP in HIV transmission among HIV-uninfected high risk populations. The purpose of this study was to evaluat...

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Autores principales: Junjun Jiang, Xiaoyi Yang, Li Ye, Bo Zhou, Chuanyi Ning, Jiegang Huang, Bingyu Liang, Xiaoni Zhong, Ailong Huang, Renchuan Tao, Cunwei Cao, Hui Chen, Hao Liang
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Publicado: Public Library of Science (PLoS) 2014
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spelling oai:doaj.org-article:5f4097fc2ab0476da489fed72153d3d62021-11-18T08:34:13ZPre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.1932-620310.1371/journal.pone.0087674https://doaj.org/article/5f4097fc2ab0476da489fed72153d3d62014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24498350/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Nearly ten randomized controlled trials (RCTs) of pre-exposure prophylaxis (PrEP) have been completed or are ongoing worldwide to evaluate the effectiveness of PrEP in HIV transmission among HIV-uninfected high risk populations. The purpose of this study was to evaluate the role of PrEP to prevent HIV transmission through a Mata-analysis.<h4>Methods</h4>A comprehensive computerized literature search was carried out in PubMed, EMbase, Ovid, Web of Science, Science Direct, Wan Fang, CNKI and related websites to collect relevant articles (from their establishment date to August 30, 2013). The search terms were "pre-exposure prophylaxis", "high risk population", "HIV infection", "reduction", "relative risk" and "efficacy". We included any RCT assessing PrEP for the prevention of HIV infection in high risk populations. Interventions of the studies were continuously daily or intermittent doses of single or compound antiretrovirals (ARVs) before HIV exposure or during HIV exposure. A meta-analysis was conducted using Stata 10.0. A random-effects method was used to calculate the pooled relative risk (RR) and 95% confidence intervals (CI) for all studies included.<h4>Results</h4>Seven RCTs involving 14,804 individuals in high risk populations were eligible for this study. The number of subjects in the experimental groups was 8,195, with HIV infection rate of 2.03%. The number of subjects in the control groups was 6,609, with HIV infection rate of 4.07%. The pooled RR was 0.53 (95% CI = 0.40 ∼ 0.71, P<0.001). The re-analyzed pooled RR were 0.61 (95% CI = 0.48 ∼ 0.77, P<0.001), 0.49 (95% CI = 0.38 ∼ 0.63, P<0.001), respectively, by excluding the largest study or two studies without statistical significance. Publication bias analysis revealed a symmetry funnel plot. The fail-safe number was 1,022.<h4>Conclusion</h4>These results show that PrEP is an effective strategy for reducing new HIV infections in high risk populations.Junjun JiangXiaoyi YangLi YeBo ZhouChuanyi NingJiegang HuangBingyu LiangXiaoni ZhongAilong HuangRenchuan TaoCunwei CaoHui ChenHao LiangPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 2, p e87674 (2014)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Junjun Jiang
Xiaoyi Yang
Li Ye
Bo Zhou
Chuanyi Ning
Jiegang Huang
Bingyu Liang
Xiaoni Zhong
Ailong Huang
Renchuan Tao
Cunwei Cao
Hui Chen
Hao Liang
Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
description <h4>Background</h4>Nearly ten randomized controlled trials (RCTs) of pre-exposure prophylaxis (PrEP) have been completed or are ongoing worldwide to evaluate the effectiveness of PrEP in HIV transmission among HIV-uninfected high risk populations. The purpose of this study was to evaluate the role of PrEP to prevent HIV transmission through a Mata-analysis.<h4>Methods</h4>A comprehensive computerized literature search was carried out in PubMed, EMbase, Ovid, Web of Science, Science Direct, Wan Fang, CNKI and related websites to collect relevant articles (from their establishment date to August 30, 2013). The search terms were "pre-exposure prophylaxis", "high risk population", "HIV infection", "reduction", "relative risk" and "efficacy". We included any RCT assessing PrEP for the prevention of HIV infection in high risk populations. Interventions of the studies were continuously daily or intermittent doses of single or compound antiretrovirals (ARVs) before HIV exposure or during HIV exposure. A meta-analysis was conducted using Stata 10.0. A random-effects method was used to calculate the pooled relative risk (RR) and 95% confidence intervals (CI) for all studies included.<h4>Results</h4>Seven RCTs involving 14,804 individuals in high risk populations were eligible for this study. The number of subjects in the experimental groups was 8,195, with HIV infection rate of 2.03%. The number of subjects in the control groups was 6,609, with HIV infection rate of 4.07%. The pooled RR was 0.53 (95% CI = 0.40 ∼ 0.71, P<0.001). The re-analyzed pooled RR were 0.61 (95% CI = 0.48 ∼ 0.77, P<0.001), 0.49 (95% CI = 0.38 ∼ 0.63, P<0.001), respectively, by excluding the largest study or two studies without statistical significance. Publication bias analysis revealed a symmetry funnel plot. The fail-safe number was 1,022.<h4>Conclusion</h4>These results show that PrEP is an effective strategy for reducing new HIV infections in high risk populations.
format article
author Junjun Jiang
Xiaoyi Yang
Li Ye
Bo Zhou
Chuanyi Ning
Jiegang Huang
Bingyu Liang
Xiaoni Zhong
Ailong Huang
Renchuan Tao
Cunwei Cao
Hui Chen
Hao Liang
author_facet Junjun Jiang
Xiaoyi Yang
Li Ye
Bo Zhou
Chuanyi Ning
Jiegang Huang
Bingyu Liang
Xiaoni Zhong
Ailong Huang
Renchuan Tao
Cunwei Cao
Hui Chen
Hao Liang
author_sort Junjun Jiang
title Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
title_short Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
title_full Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
title_fullStr Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
title_full_unstemmed Pre-exposure prophylaxis for the prevention of HIV infection in high risk populations: a meta-analysis of randomized controlled trials.
title_sort pre-exposure prophylaxis for the prevention of hiv infection in high risk populations: a meta-analysis of randomized controlled trials.
publisher Public Library of Science (PLoS)
publishDate 2014
url https://doaj.org/article/5f4097fc2ab0476da489fed72153d3d6
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