Pre-exposure prophylaxis (PrEP), is the use of

medications Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...

to prevent the spread of disease in people who have not yet been exposed to a disease-causing agent.

Vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating ...

is the most commonly used form of pre-exposure

prophylaxis Preventive healthcare, or prophylaxis, is the application of healthcare measures to prevent diseases.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental health a ...

; other forms of pre-exposure prophylaxis generally involve drug treatment, known as chemoprophylaxis. Examples include taking medication to prevent infection by

malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...

or HIV. In particular, the term ''PrEP'' is now synonymous in popular usage with the use of pre-exposure prophylaxis for HIV prevention. In general, the use of pre-exposure prophylaxis requires balancing the risks of the treatment (e.g.,

side effects In medicine, a side effect is an effect of the use of a medicinal drug or other treatment, usually adverse but sometimes beneficial, that is unintended. Herbal and traditional medicines also have side effects. A drug or procedure usually used ...

from a drug) to healthy individuals with the risk of the disease. It should be contrasted with

post-exposure prophylaxis Post-exposure prophylaxis, also known as post-exposure prevention (PEP), is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring. It should be contrasted with pre-exposure prophy ...

, which is used once the patient has already been exposed to the infectious agent.

Use of pre-exposure medication against specific diseases

Malaria

The use of pre-exposure drug treatment to prevent

using antimalarial drugs is well-established, with the use of

quinine Quinine is a medication used to treat malaria and babesiosis. This includes the treatment of malaria due to ''Plasmodium falciparum'' that is resistant to chloroquine when artesunate is not available. While sometimes used for nocturnal leg ...

as a prophylactic treatment dating back at least to the 19th century.

HIV/AIDS

The abbreviation PrEP now typically refers to pre-exposure prophylaxis for HIV prevention, the use of antiviral drugs as a strategy for the

prevention of HIV/AIDS HIV prevention refers to practices that aim to prevent the spread of the HIV/AIDS, human immunodeficiency virus (HIV). HIV prevention practices may be undertaken by individuals to protect Self care, their own health and the health of those in thei ...

. PrEP is one of a number of HIV prevention strategies for people who are HIV negative but who have a higher risk of acquiring HIV, including sexually active adults at increased risk of contracting HIV, people who engage in intravenous drug use (see drug injection), and serodiscordant sexually active couples. When used as directed, PrEP has been shown to be highly effective at preventing HIV infection, reducing the risk of acquiring HIV by up to 99%. A large-scale study in the UK has shown that PrEP remains effective at preventing HIV infection, even when used in uncontrolled environments.

COVID-19

Pre-exposure prophylaxis against infection by

SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...

, the virus that causes

COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...

, has been studied as a possible preventive measure for high-risk groups. In December 2021, the US FDA granted emergency use authorization (EUA) of the antibody drug tixagevimab/cilgavimab (Evusheld) to prevent COVID-19 in immunocompromised people who cannot be fully vaccinated due to a history of a severe reaction to coronavirus vaccines. However, due to the high levels of non-susceptible SARS-CoV-2 variants present in the US, the FDA announced on 6 January 2023 that tixagevimab/cilgavimab was no longer currently authorized for emergency use in the US. In March 2024, pemivibart (Pemgarda), a

monoclonal antibody A monoclonal antibody (mAb, more rarely called moAb) is an antibody produced from a cell lineage made by cloning a unique white blood cell. All subsequent antibodies derived this way trace back to a unique parent cell. Monoclonal antibodie ...

drug, received an emergency use authorization from the US FDA to protect certain moderately to severely immunocompromised individuals against COVID-19.

Pre-exposure prophylaxis for post-mortems

Since conducting autopsies may involve inadvertent cuts, and the incidence of hepatitis-B can be very high in certain populations, it is advisable for all autopsy personnel to get their hepatitis-B antibody status tested. If antibodies are not present in sufficient concentrations, a hepatitis-B vaccine is recommended.

References

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