POST-EKSPOZICIONA I PRE-EKSPOZICIONA PROFILAKSA KAO MERE PREVENCIJE HIV  INFEKCIJE

Slađana   Baroš; Sandra Grujičić

doi:10.5937/zdravzast51-41701

Slađana Baroš Centar za kontrolu i prevenciju bolesti, Odeljenje za HIV, PPI, virusne hepatitise i tuberkulozu, Institut za javno zdravlje Srbije „Dr Milan Jovanović Batut”, Beograd, Republika Srbija
Sandra Grujičić Institut za epidemiologiju, Medicinski fakultet Univerziteta u Beogradu, Beograd, Republika Srbijabija

DOI: https://doi.org/10.5937/zdravzast51-41701

Ključne reči: post-ekspoziciona profilaksa, pre-ekspoziciona profilaksa, HIV infekcija, AIDS, zdravstveni radnici, biomedicinske intervencije

Sažetak

Hemioprofilaksa u prevenciji HIV infekcije praktično počinje da se koristi od registrovanja prvog leka za lečenje AIDS-a odnosno od 1987. godine. Post-ekspoziciona profilaksa (PEP) koju koriste osobe akcidentalno eksponirane HIV infekciji uglavnom je vezana za profesionalnu akcidentalnu izloženost HIV infekciji (primarno zdravstvenih radnika). Procenjuje se da PEP smanjuje rizik za 81% od HIV infekcije. Pre-ekspoziciona profilaksa (PrEP) je počela više da se ispituje i primenjuje pre desetak godina. PrEP je namenjena osobama koje nisu inficirane HIV-om, ali su u kontinuiranom riziku od HIV-a usled svog rizičnog ponašanja. Procenjuje se da PrEP smanjuje rizik od nastanka HIV infekcije za 75% i više u zavisnosti od populacije i adherencije propisanom terapijskom režimu. U Srbiji PEP i PrEP i dalje nisu potpuno regulisane, ali je rad na tome počeo 2022. godine. U zemljama sa neregulisanom PrEP prisutan je rizik od neformalne upotrebe terapije bez medicinskog nadzora, što može da dovede do manje efikasnosti PrEP i razvoja rezistentntnih oblika HIV infekcije u slučaju prethodno nedijagnostikovane HIV infekcije. Obe intervencije pripadaju biomedicinskim intervencijama vezanim za prevenciju HIV infekcije i od značaja su za dosezanje globalnih ciljeva usmerenih na okončanje AIDS-a kao „javnozdravstvene pretnje” do 2030. godine. Međutim, da bi biomedicinske intervencije bile maksimalno efikasne, potrebno je da budu praćene adekvatnim bihejvioralnim intervencijama u cilju povećanja informisanosti, adherencije propisanom terapijskom režimu i periodične kontrole zdravstvenog stanja u skladu sa definisanim preporukama za PEP i PrEP.

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