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. 2013 Jul 31;10:82.
doi: 10.1186/1742-4690-10-82.

Evolving Uses of Oral Reverse Transcriptase Inhibitors in the HIV-1 Epidemic: From Treatment to Prevention

Free PMC article

Evolving Uses of Oral Reverse Transcriptase Inhibitors in the HIV-1 Epidemic: From Treatment to Prevention

Ravindra K Gupta et al. Retrovirology. .
Free PMC article


The HIV epidemic continues unabated, with no highly effective vaccine and no cure. Each new infection has significant economic, social and human costs and prevention efforts are now as great a priority as global antiretroviral therapy (ART) scale up. Reverse transcriptase inhibitors, the first licensed class of ART, have been at the forefront of treatment and prevention of mother to child transmission over the past two decades. Now, their use in adult prevention is being extensively investigated. We describe two approaches: treatment as prevention (TasP) - the use of combination ART (2NRTI and 1NNRTI) following HIV diagnosis to limit transmission and pre-exposure prophylaxis (PrEP) -the use of single or dual oral agents prior to sexual exposure. Prevention of mother-to-child transmission using NRTI has been highly successful, though does not involve sustained use of NRTI to limit transmission. Despite theoretical and preliminary support for TasP and PrEP, data thus far indicate that adherence, retention in care and late diagnosis are the major barriers to their successful, sustained implementation. Future advances in drug technologies will be needed to overcome the issue of drug adherence, through development of drugs that involve both less frequent dosing as well as reduced toxicity, possibly through specific targeting of infected cells.

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    1. WHO. Global HIV/AIDS response: epidemic update and health sector progress towards universal access: progress report 2011. 2011. Available from:
    1. UNAIDS. Together we will end AIDS. 2012. [cited 2012 5th September]; Available from:
    1. UNAIDS. UNAIDS Report on the global AIDS epidemic 2011. 2011. [cited 2012 31st May 2012]; Available from:
    1. Mermin J. et al. Mortality in HIV-infected Ugandan adults receiving antiretroviral treatment and survival of their HIV-uninfected children: a prospective cohort study. Lancet. 2008;371(9614):752–759. doi: 10.1016/S0140-6736(08)60345-1. - DOI - PubMed
    1. Bor J. et al. Increases in adult life expectancy in rural South Africa: valuing the scale-up of HIV treatment. Science. 2013;339(6122):961–965. doi: 10.1126/science.1230413. - DOI - PMC - PubMed

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