La prévention pré-exposition au VIH-1 par les antirétroviraux, la PrEP.

Due to the lack of vaccine, the HIV epidemic is still uncontrolled. Use of antiretrovirals (ARV) for prevention, successfully implemented to prevent mother-to-child transmission of HIV, is a new avenue to control the epidemic. One approach is to treat all patients diagnosed with HIV, and suppress viremia and transmission to their partner. Another strategy is the use of ARV as a pre-exposition prophylaxis (PrEP) in HIV-negative at risk individuals. Oral tenofovir (TDF) ± emtricitabine (FTC) is the elected drug regimen for PrEP, given its safety, its long intracellular half-life and a high diffusion into mucosal entry sites. PrEP was investigated in randomized trials of oral or local gel given daily or at time of sexual intercourse in high-risk populations. PrEP efficacy is strongly correlated to adherence and concentrations of ARV. Adverse events have been infrequent. Selection of FTC-resistant strains has been mainly reported in undiagnosed HIV-infected participants using PrEP. PrEP is now strongly recommended by WHO in prevention programs for HIV in order to control the epidemic by 2030.